Provider Demographics
NPI:1669724100
Name:HALBERG, MICHELLE A (CPC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:A
Last Name:HALBERG
Suffix:
Gender:F
Credentials:CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8321 MOUNTAIN HEATHER CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-4521
Mailing Address - Country:US
Mailing Address - Phone:858-254-8980
Mailing Address - Fax:
Practice Address - Street 1:1840 E CALVADA BLVD STE 11
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-5865
Practice Address - Country:US
Practice Address - Phone:702-265-3255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-08
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCP0135101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health