Provider Demographics
NPI:1568123552
Name:HYDUKE, MICHAELA (LMHC)
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:
Last Name:HYDUKE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 SCREVEN PL
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-1858
Mailing Address - Country:US
Mailing Address - Phone:912-484-4336
Mailing Address - Fax:
Practice Address - Street 1:353 LEXINGTON AVE STE 317
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0941
Practice Address - Country:US
Practice Address - Phone:124-844-3369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY011965101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health