Provider Demographics
NPI:1396158283
Name:WEILL, MICHELLE (LCPC)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:WEILL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10005 OLD COLUMBIA RD
Mailing Address - Street 2:UNIT L260
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1702
Mailing Address - Country:US
Mailing Address - Phone:443-259-0400
Mailing Address - Fax:
Practice Address - Street 1:10005 OLD COLUMBIA RD
Practice Address - Street 2:UNIT L260
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1702
Practice Address - Country:US
Practice Address - Phone:443-259-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC7003101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health