Provider Demographics
NPI:1568237790
Name:PLATZ, MICHELLE L (LMHC-A)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:PLATZ
Suffix:
Gender:F
Credentials:LMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 N OAK ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46725-1608
Mailing Address - Country:US
Mailing Address - Phone:260-244-0264
Mailing Address - Fax:260-244-1983
Practice Address - Street 1:360 N OAK ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA CITY
Practice Address - State:IN
Practice Address - Zip Code:46725-1608
Practice Address - Country:US
Practice Address - Phone:260-244-0264
Practice Address - Fax:260-244-1983
Is Sole Proprietor?:No
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1613774101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool