Provider Demographics
NPI:1659913432
Name:MCLAUGHLIN, MICHELLE CONLEY (LGPC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CONLEY
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5215 WIGVILLE RD UNIT I
Mailing Address - Street 2:
Mailing Address - City:THURMONT
Mailing Address - State:MD
Mailing Address - Zip Code:21788-1400
Mailing Address - Country:US
Mailing Address - Phone:757-604-2979
Mailing Address - Fax:
Practice Address - Street 1:12242 BRITTANIA CIR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-2583
Practice Address - Country:US
Practice Address - Phone:301-740-6643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-12
Last Update Date:2019-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP7151101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health