Michele Stanford, PCS
Individual provider Active NPI Professional Counselor · Manchester, GA
NPI 1467907378 · NPPES record last updated Dec 7, 2016
Key facts
- NPI
- 1467907378
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 08172013-03R (GA)
- Practice address
- 176 Gilbert Rd
Manchester, GA 31816-7021 - Phone
- (706) 975-0079
- Fax
- (706) 441-0043
- NPI assigned
- Aug 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08172013-03R | GA | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 08172013-03R | GA | Yes |
| Pastoral Counselor | 101YP1600X | 08172013-03R | GA |
Addresses
Primary practice location
176 Gilbert Rd
Manchester, GA 31816-7021
Mailing address
176 Gilbert Rd
Manchester, GA 31816-7021
Phone (706) 975-0079
Other providers in Manchester, GA
- Aja Perry
- Richard L Ousley DDS PC
- Edward T Rocereta
- Theodora Seigfred
- Smith-Lambert Clinic, P.C.
- Varsha Nicole Steverson
- Thompson Clinic, LLC
- Patricia Ann Tribble
- Walgreen Co
- Elizabeth Williams
All providers in Manchester, GA · Professional Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.