Provider Demographics
NPI:1912137571
Name:BRANDELL, MICHAELA (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:
Last Name:BRANDELL
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16501 RED CLIFF DR
Mailing Address - Street 2:APARTMENT 2H
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-3873
Mailing Address - Country:US
Mailing Address - Phone:828-315-7718
Mailing Address - Fax:
Practice Address - Street 1:101 GOVERNMENT AVE SW
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-2936
Practice Address - Country:US
Practice Address - Phone:828-315-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.012002101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional