Provider Demographics
NPI:1679002125
Name:WESTFALL, MICHALA NICOLE (LSW)
Entity Type:Individual
Prefix:MRS
First Name:MICHALA
Middle Name:NICOLE
Last Name:WESTFALL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 BUCHANAN ST
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:IL
Mailing Address - Zip Code:62321-1401
Mailing Address - Country:US
Mailing Address - Phone:217-357-3176
Mailing Address - Fax:217-357-6609
Practice Address - Street 1:607 BUCHANAN ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:IL
Practice Address - Zip Code:62321-1401
Practice Address - Country:US
Practice Address - Phone:217-357-3176
Practice Address - Fax:217-357-6609
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IL150.110794104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health