Provider Demographics
NPI:1659015477
Name:MICHEL, HANCY
Entity Type:Individual
Prefix:
First Name:HANCY
Middle Name:
Last Name:MICHEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-5924
Mailing Address - Country:US
Mailing Address - Phone:562-428-4222
Mailing Address - Fax:
Practice Address - Street 1:100 E MARKET ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-5924
Practice Address - Country:US
Practice Address - Phone:562-428-4222
Practice Address - Fax:562-428-0372
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA150880101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)