Provider Demographics
NPI:1871281980
Name:MICHELE M GOUIN, LMSW, LLC
Entity type:Organization
Organization Name:MICHELE M GOUIN, LMSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GOUIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:989-312-0211
Mailing Address - Street 1:3050 N DOW RD
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-9420
Mailing Address - Country:US
Mailing Address - Phone:989-312-0211
Mailing Address - Fax:
Practice Address - Street 1:3050 N DOW RD
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-9420
Practice Address - Country:US
Practice Address - Phone:989-312-0211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty