Provider Demographics
NPI:1255458188
Name:ALEXANDER, MICHELLE BATACAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:BATACAN
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:SPELLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 628
Mailing Address - Street 2:619 FRANKLIN STREET SUITE 2B
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46361-0628
Mailing Address - Country:US
Mailing Address - Phone:219-877-8921
Mailing Address - Fax:
Practice Address - Street 1:619 FRANKLIN ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-3411
Practice Address - Country:US
Practice Address - Phone:219-877-8921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34001999A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical