Provider Demographics
NPI:1659097251
Name:FLUKE, MICHELE ANNE (LMHC #19446)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANNE
Last Name:FLUKE
Suffix:
Gender:F
Credentials:LMHC #19446
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 HACKNEY AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2309
Mailing Address - Country:US
Mailing Address - Phone:407-484-1327
Mailing Address - Fax:
Practice Address - Street 1:4070 ALOMA AVE STE 1030
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-9315
Practice Address - Country:US
Practice Address - Phone:407-559-9013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19446101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health