Provider Demographics
NPI:1366879629
Name:ALLISON, MICHELLE RENE (LPC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RENE
Last Name:ALLISON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:RENE
Other - Last Name:KOLCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:426 KOLCH LN
Mailing Address - Street 2:
Mailing Address - City:ELLWOOD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16117-1560
Mailing Address - Country:US
Mailing Address - Phone:724-944-6250
Mailing Address - Fax:
Practice Address - Street 1:130 W NORTH ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-3906
Practice Address - Country:US
Practice Address - Phone:724-658-3578
Practice Address - Fax:724-656-1325
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007151101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional