Provider Demographics
NPI:1457632481
Name:FIELDER, MICHELLE VAN EXEL (PHD, LPC, LPCC, NCC)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:VAN EXEL
Last Name:FIELDER
Suffix:
Gender:F
Credentials:PHD, LPC, LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 S CAMPBELL AVE BLDG 2
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-0502
Mailing Address - Country:US
Mailing Address - Phone:520-407-5600
Mailing Address - Fax:520-407-5990
Practice Address - Street 1:281 INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 326
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-2986
Practice Address - Country:US
Practice Address - Phone:757-490-0377
Practice Address - Fax:757-497-1327
Is Sole Proprietor?:No
Enumeration Date:2011-09-04
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-22207101YP2500X
VA0701005104101YP2500X
ORC7256101YP2500X
CALPCC12927101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional