Provider Demographics
NPI:1215162722
Name:MARTIN, MICHELLE (LMSW)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:LAMBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 MICHIGAN ST
Mailing Address - Street 2:STE 327
Mailing Address - City:HANCOCK
Mailing Address - State:MI
Mailing Address - Zip Code:49930-1448
Mailing Address - Country:US
Mailing Address - Phone:906-231-1320
Mailing Address - Fax:
Practice Address - Street 1:200 MICHIGAN ST
Practice Address - Street 2:STE 327
Practice Address - City:HANCOCK
Practice Address - State:MI
Practice Address - Zip Code:49930-1448
Practice Address - Country:US
Practice Address - Phone:906-231-1320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010902221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical