Provider Demographics
NPI:1700140183
Name:GOUIN, MICHELE M (MSW, LMSW)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:M
Last Name:GOUIN
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 N DOW RD
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-9420
Mailing Address - Country:US
Mailing Address - Phone:989-965-5636
Mailing Address - Fax:
Practice Address - Street 1:3050 N DOW RD
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-9420
Practice Address - Country:US
Practice Address - Phone:989-965-5636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011161371041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical