Provider Demographics
NPI:1578760062
Name:CHAVES, MICHELE ANTOINETTE (MFTI)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:ANTOINETTE
Last Name:CHAVES
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:MS
Other - First Name:MICHELE
Other - Middle Name:ANTOINETTE
Other - Last Name:CHAVES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFTI 52462
Mailing Address - Street 1:2261 ELM ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-3721
Mailing Address - Country:US
Mailing Address - Phone:707-253-4711
Mailing Address - Fax:707-251-1070
Practice Address - Street 1:2261 ELM ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-3721
Practice Address - Country:US
Practice Address - Phone:707-253-4711
Practice Address - Fax:707-251-1070
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFTI 52462101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health