Provider Demographics
NPI:1366286569
Name:LEHNER, MICHELE (SHELLY)
Entity type:Individual
Prefix:
First Name:MICHELE (SHELLY)
Middle Name:
Last Name:LEHNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3854 HAZEL ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55110-4324
Mailing Address - Country:US
Mailing Address - Phone:651-792-5439
Mailing Address - Fax:
Practice Address - Street 1:790 CLEVELAND AVE S STE 217
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-3845
Practice Address - Country:US
Practice Address - Phone:651-280-4439
Practice Address - Fax:651-560-3768
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty