Provider Demographics
NPI:1821368887
Name:HOSSINEI, MICHELLE MARIE
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:HOSSINEI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2224 S CROATAN HWY
Mailing Address - Street 2:D7, PMB 21
Mailing Address - City:NAGS HEAD
Mailing Address - State:NC
Mailing Address - Zip Code:27959-8813
Mailing Address - Country:US
Mailing Address - Phone:252-255-2733
Mailing Address - Fax:252-255-0787
Practice Address - Street 1:2224 S CROATAN HWY
Practice Address - Street 2:D7, PMB 21
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-8813
Practice Address - Country:US
Practice Address - Phone:252-255-2733
Practice Address - Fax:252-255-0787
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20342101YA0400X
NC1597106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)