Provider Demographics
NPI:1366480956
Name:UNSWORTH, MICHELE JEAN (LCPC)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:JEAN
Last Name:UNSWORTH
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 E FERNAN CT
Mailing Address - Street 2:
Mailing Address - City:COEUR D'ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814
Mailing Address - Country:US
Mailing Address - Phone:208-861-1762
Mailing Address - Fax:208-367-9242
Practice Address - Street 1:3009 E FERNAN CT
Practice Address - Street 2:
Practice Address - City:COEUR D'ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814
Practice Address - Country:US
Practice Address - Phone:208-861-1762
Practice Address - Fax:208-367-9242
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-3312101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional