Provider Demographics
NPI:1558542431
Name:TRABULSY, MICHAEL G (LMHC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:G
Last Name:TRABULSY
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1533
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33846-1533
Mailing Address - Country:US
Mailing Address - Phone:863-937-9152
Mailing Address - Fax:863-937-9154
Practice Address - Street 1:2225 E EDGEWOOD DR
Practice Address - Street 2:STE 11
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-3634
Practice Address - Country:US
Practice Address - Phone:863-937-9152
Practice Address - Fax:863-937-9154
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 5984101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health