Provider Demographics
NPI:1528879111
Name:PAINE, MICHELLE (LPCC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:PAINE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 QUEEN CITY CIR
Mailing Address - Street 2:
Mailing Address - City:PARACHUTE
Mailing Address - State:CO
Mailing Address - Zip Code:81635-9446
Mailing Address - Country:US
Mailing Address - Phone:720-201-1763
Mailing Address - Fax:
Practice Address - Street 1:42 QUEEN CITY CIR
Practice Address - Street 2:
Practice Address - City:PARACHUTE
Practice Address - State:CO
Practice Address - Zip Code:81635-9446
Practice Address - Country:US
Practice Address - Phone:720-201-1763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0022782101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health