Provider Demographics
NPI:1568786275
Name:LURIE, MICHELLE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:LURIE
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 1:3944 SAN SIMEON LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-5059
Mailing Address - Country:US
Mailing Address - Phone:954-647-6523
Mailing Address - Fax:
Practice Address - Street 1:1750 N UNIVERSITY DR
Practice Address - Street 2:SUITE 201
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-8903
Practice Address - Country:US
Practice Address - Phone:954-755-8247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 9881101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health