Provider Demographics
NPI:1558779959
Name:MCLAUGHLIN, MICHE (LMSW)
Entity Type:Individual
Prefix:
First Name:MICHE
Middle Name:
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 MESA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-3717
Mailing Address - Country:US
Mailing Address - Phone:817-914-3370
Mailing Address - Fax:
Practice Address - Street 1:320 MESA VISTA DR
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-3717
Practice Address - Country:US
Practice Address - Phone:817-914-3370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54320104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker