Provider Demographics
NPI:1487856811
Name:MICHEL, CHESTER R (LPC)
Entity type:Individual
Prefix:
First Name:CHESTER
Middle Name:R
Last Name:MICHEL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1910
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-1910
Mailing Address - Country:US
Mailing Address - Phone:417-464-8160
Mailing Address - Fax:
Practice Address - Street 1:4602 N QUAIL RUN RD
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-6246
Practice Address - Country:US
Practice Address - Phone:417-464-8160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001033782101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional