Provider Demographics
NPI:1609467265
Name:OSBORNE, MICHELLE LACHETTE (LCDC)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LACHETTE
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4908 TORREY LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-1884
Mailing Address - Country:US
Mailing Address - Phone:682-346-6219
Mailing Address - Fax:
Practice Address - Street 1:4908 TORREY LN APT 503
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1831
Practice Address - Country:US
Practice Address - Phone:682-346-6219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-27
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15594101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)