Individual
SEAN ALEXANDER MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Contact information
Practice address
1515 LIBERTY ST SE, SALEM, OR 97302-4345
(503) 951-6280
(503) 468-3130
Mailing address
1515 LIBERTY ST SE, SALEM, OR 97302-4345
(503) 951-6280
(503) 468-3130
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C6214
OR
Other
Enumeration date
12/16/2014
Last updated
06/15/2021
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