Provider Demographics
NPI:1285863555
Name:BEALS, MICHELLE JOY (LLMSW CAAC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:JOY
Last Name:BEALS
Suffix:
Gender:F
Credentials:LLMSW CAAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:49444-1409
Mailing Address - Country:US
Mailing Address - Phone:231-288-9936
Mailing Address - Fax:
Practice Address - Street 1:5353 GRAND HAVEN RD
Practice Address - Street 2:SUITE B
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49441-5985
Practice Address - Country:US
Practice Address - Phone:231-799-8183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010896281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical