Provider Demographics
NPI:1609216142
Name:KEGLEY, MICHELLE (LMHC, LPC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:KEGLEY
Suffix:
Gender:F
Credentials:LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 N FEDERAL HWY STE 206-7
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6057
Mailing Address - Country:US
Mailing Address - Phone:404-496-8849
Mailing Address - Fax:404-591-7909
Practice Address - Street 1:3200 N FEDERAL HWY STE 206-7
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6057
Practice Address - Country:US
Practice Address - Phone:404-496-8849
Practice Address - Fax:404-591-7909
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-28
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008859101YP2500X
FLMH22247101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
1609216142OtherNPPES