Provider Demographics
NPI:1134583750
Name:TSAI OWENS, MICHELE SHYUAN (PHD)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:SHYUAN
Last Name:TSAI OWENS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:TSAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 778912
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-8912
Mailing Address - Country:US
Mailing Address - Phone:317-777-6435
Mailing Address - Fax:317-777-6644
Practice Address - Street 1:11590 N MERIDIAN ST STE 300
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4529
Practice Address - Country:US
Practice Address - Phone:317-944-8906
Practice Address - Fax:317-944-9330
Is Sole Proprietor?:No
Enumeration Date:2016-04-09
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20043391B103TC2200X
MN.2084P0800X
IN20043391A103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300042808Medicaid