Provider Demographics
NPI:1881104800
Name:METZLER, MICHELLE A (LCMHC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:A
Last Name:METZLER
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 HEGEMAN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-3187
Mailing Address - Country:US
Mailing Address - Phone:802-489-7235
Mailing Address - Fax:802-497-1321
Practice Address - Street 1:462 HEGEMAN AVE STE 100
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-3187
Practice Address - Country:US
Practice Address - Phone:802-489-7235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT168.0117920101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty