Provider Demographics
NPI:1205900206
Name:GAROFANO, MICHAEL (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:GAROFANO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HERMAN AVENUE EXT STE B
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-9106
Mailing Address - Country:US
Mailing Address - Phone:828-713-7922
Mailing Address - Fax:267-295-1097
Practice Address - Street 1:6 HERMAN AVENUE EXT STE B
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-9106
Practice Address - Country:US
Practice Address - Phone:828-713-7922
Practice Address - Fax:267-295-1097
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04034103G00000X, 103T00000X
CAPSY13584103G00000X, 103T00000X
NC2772103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist