Provider Demographics
NPI:1881823078
Name:SHAMBO, MICHELLE LEIGH (LPCC, LMHC)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LEIGH
Last Name:SHAMBO
Suffix:
Gender:F
Credentials:LPCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 OSAGE CIR
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93514-7466
Mailing Address - Country:US
Mailing Address - Phone:760-873-8980
Mailing Address - Fax:
Practice Address - Street 1:44 OSAGE CIR
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514-7466
Practice Address - Country:US
Practice Address - Phone:360-266-0778
Practice Address - Fax:360-748-4762
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2017-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60017481101YM0800X
CALPC 407101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional