Provider Demographics
NPI:1023701299
Name:AUGUST, MICHELLE EMERY (MA)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:EMERY
Last Name:AUGUST
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:MEEK
Other - Last Name:CORIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4930 WHETSEL AVE UNIT 321
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-2383
Mailing Address - Country:US
Mailing Address - Phone:614-906-1572
Mailing Address - Fax:
Practice Address - Street 1:5720 GATEWAY STE 204
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1891
Practice Address - Country:US
Practice Address - Phone:513-445-9959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2305381101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health