Individual
MS. MICHELLE BETH SUPPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
200 EAST MAIN ST, MILFORD, MA 01757
(508) 634-1877
(508) 634-1878
Mailing address
200 EAST MAIN ST, MILFORD, MA 01757
(508) 634-1877
(508) 634-1878
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6080
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306421
—
MA
01
—
1308785
MCD MH
MA
01
—
2220002001
BCBS MA SA
MA
01
—
M18684
BCBS MH
—
Enumeration date
09/21/2006
Last updated
03/05/2024
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