Provider Demographics
NPI:1134557549
Name:COMER, MICHALA (LPC)
Entity type:Individual
Prefix:
First Name:MICHALA
Middle Name:
Last Name:COMER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 SE 591ST RD
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-9368
Mailing Address - Country:US
Mailing Address - Phone:660-909-1748
Mailing Address - Fax:660-362-1332
Practice Address - Street 1:598 SE DD HWY STE 1
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093
Practice Address - Country:US
Practice Address - Phone:660-909-1748
Practice Address - Fax:660-909-1748
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO6759101YA0400X
MO2013006838101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)