Provider Demographics
NPI:1699813105
Name:MICHAELSON-CHMELIR, TERESA M (PHD, LMHC, NCC)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:M
Last Name:MICHAELSON-CHMELIR
Suffix:
Gender:F
Credentials:PHD, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 PARK EDEN CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-1900
Mailing Address - Country:US
Mailing Address - Phone:407-947-2899
Mailing Address - Fax:407-296-6834
Practice Address - Street 1:4550 PARK EDEN CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-1900
Practice Address - Country:US
Practice Address - Phone:407-947-2899
Practice Address - Fax:407-296-6834
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 5574101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health