Provider Demographics
NPI:1548680770
Name:DEVAUL, MICHELLE ELAINE (LPC)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:ELAINE
Last Name:DEVAUL
Suffix:
Gender:F
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 87415
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30337-0415
Mailing Address - Country:US
Mailing Address - Phone:678-427-7533
Mailing Address - Fax:
Practice Address - Street 1:100 EDGEWOOD AVE NE
Practice Address - Street 2:SUITE 1800
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3026
Practice Address - Country:US
Practice Address - Phone:404-591-7051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-28
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006229101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional