Provider Demographics
NPI:1558536862
Name:JOHN WALTER MICHELS; STEP BY STEP COUNSELING SERVICES
Entity Type:Organization
Organization Name:JOHN WALTER MICHELS; STEP BY STEP COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:MICHELS
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC LSOTP
Authorized Official - Phone:806-224-3947
Mailing Address - Street 1:3610 AVENUE Q
Mailing Address - Street 2:STE 213
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79412-1246
Mailing Address - Country:US
Mailing Address - Phone:806-224-3947
Mailing Address - Fax:
Practice Address - Street 1:3610 AVENUE Q
Practice Address - Street 2:STE 213
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-1246
Practice Address - Country:US
Practice Address - Phone:806-224-3947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17210251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147453801Medicaid