Provider Demographics
NPI:1982859013
Name:TICHELI, A. MICHELLE (LPC, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:A.
Middle Name:MICHELLE
Last Name:TICHELI
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 BRES AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5915
Mailing Address - Country:US
Mailing Address - Phone:318-322-0037
Mailing Address - Fax:
Practice Address - Street 1:1921 PARK AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3405
Practice Address - Country:US
Practice Address - Phone:251-586-2168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3017101YP2500X
LA1100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist