Provider Demographics
NPI:1710252291
Name:KLEAR, MICHELLE LOUISE (MS LLPC)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LOUISE
Last Name:KLEAR
Suffix:
Gender:F
Credentials:MS LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 E GRAND RIVER AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-1878
Mailing Address - Country:US
Mailing Address - Phone:810-588-4236
Mailing Address - Fax:
Practice Address - Street 1:810 E GRAND RIVER AVE
Practice Address - Street 2:STE 101
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-1878
Practice Address - Country:US
Practice Address - Phone:810-588-4236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-15
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012971101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor