Provider Demographics
NPI:1912516048
Name:MICHELLE DUTCHER MA, LPC, PLLC
Entity type:Organization
Organization Name:MICHELLE DUTCHER MA, LPC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUTCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:248-444-3374
Mailing Address - Street 1:7325 INGOMAR LN
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-5402
Mailing Address - Country:US
Mailing Address - Phone:248-444-3374
Mailing Address - Fax:248-856-2697
Practice Address - Street 1:8040 ORTONVILLE RD STE A
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48348-4468
Practice Address - Country:US
Practice Address - Phone:248-444-3374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-24
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty