Provider Demographics
NPI:1942745880
Name:HUGGARD, MISTY (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:MISTY
Middle Name:
Last Name:HUGGARD
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E ARBUTUS LAKE RD
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49696-9449
Mailing Address - Country:US
Mailing Address - Phone:231-881-5339
Mailing Address - Fax:
Practice Address - Street 1:225 E ARBUTUS LAKE RD
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49696-9449
Practice Address - Country:US
Practice Address - Phone:231-881-5339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-02
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013711101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor