Individual
MRS. BRENDA LEE MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
311-4E JUDGES ROAD, WILMINGTON, NC 28405-3655
(910) 791-6767
(910) 791-6890
Mailing address
311-4E JUDGES ROAD, WILMINGTON, NC 28405-3655
(910) 791-6767
(910) 791-6890
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C003296
NC
1041C0700X
Clinical Social Worker
Primary
C003296
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6002054
—
NC
01
—
P00813768
RR MEDICARE
NC
Enumeration date
01/02/2007
Last updated
03/19/2012
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