Provider Demographics
NPI:1659610467
Name:LAPORTE, MICHELLE ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:ANN
Last Name:LAPORTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 ARTILLERY RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-6924
Mailing Address - Country:US
Mailing Address - Phone:540-336-6498
Mailing Address - Fax:
Practice Address - Street 1:31 S BRADDOCK ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4144
Practice Address - Country:US
Practice Address - Phone:540-336-6498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040080811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical