Individual
IAN MICHAEL MICHELIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
60 WALNUT AVE, CLARK, NJ 07066-1649
(732) 605-6029
Mailing address
117 WOODWARD AVE, RUTHERFORD, NJ 07070-2211
(551) 352-2066
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
44SL07093400
NJ
Other
Enumeration date
01/04/2025
Last updated
01/04/2025
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