Provider Demographics
NPI:1427495506
Name:O'HARE, MICHAEL ALLAN (MA, LMSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ALLAN
Last Name:O'HARE
Suffix:
Gender:M
Credentials:MA, LMSW
Other - Prefix:MR
Other - First Name:MIKE
Other - Middle Name:ALLAN
Other - Last Name:O'HARE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LMSW
Mailing Address - Street 1:1560 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-4151
Mailing Address - Country:US
Mailing Address - Phone:989-775-2284
Mailing Address - Fax:
Practice Address - Street 1:1560 WATSON RD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-4151
Practice Address - Country:US
Practice Address - Phone:989-775-2280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-29
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802084390104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker