Provider Demographics
NPI:1598147910
Name:PRESCOTT, MICHELLE V (LPC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:V
Last Name:PRESCOTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14616 W BRIAN RD
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-3807
Mailing Address - Country:US
Mailing Address - Phone:414-430-5805
Mailing Address - Fax:
Practice Address - Street 1:14616 W BRIAN RD
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-3807
Practice Address - Country:US
Practice Address - Phone:414-430-5805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2318-226101YP2500X
WI6785-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional