Provider Demographics
NPI:1922017771
Name:FLICHT-MCDONOUGH, MICHELLE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:FLICHT-MCDONOUGH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 I ST.
Mailing Address - Street 2:SUITE #204
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4421
Mailing Address - Country:US
Mailing Address - Phone:916-446-3045
Mailing Address - Fax:916-486-7062
Practice Address - Street 1:3101 I ST
Practice Address - Street 2:SUITE #204
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4421
Practice Address - Country:US
Practice Address - Phone:916-446-3045
Practice Address - Fax:916-486-7062
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS192011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical