Provider Demographics
NPI:1184172025
Name:MALHEREK, MICHELLE (MS, LPC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MALHEREK
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:BESEDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:1919 LEOPARD ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78408-3921
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4646 CORONA DR STE 140
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4302
Practice Address - Country:US
Practice Address - Phone:361-946-2256
Practice Address - Fax:469-535-9009
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-20
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72771101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional