GERALD MICKETTI (NPI# 1649660226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649660226 |
| Entity Type | Individual |
| Full Name | GERALD MICKETTI |
| Credential | LLPC |
| Practice Address |
1200 W. 11th Street Suite 111 Traverse City MI 49684-3288 |
| Mailing Address |
1200 W 11th St Ste 111 Traverse City MI 49684-3288 |
| Practice Telephone | 2314998290 |
| Mailing Telephone | 2314998290 |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2015-02-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
6401012457 | MI | Behavioral Health & Social Service Providers |
| Street Address |
1200 W. 11TH STREET SUITE 111 |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-3288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033720321 | Jeanette Fay Peltola | Counselor | 968 Harbor Ct, Traverse City, MI 49685-9355 | 2020-08-11 |
| 1922629047 | International Center for Integral Health and Education | Counselor | 263 Midtown Dr, Traverse City, MI 49684-5752 | 2020-04-29 |
| 1255961868 | Joan M Ledford | Counselor | 928 S Garfield Avenue, Suite 3a, Traverse City, MI 49686-0000 | 2020-01-23 |
| 1942840137 | Kristen Nicole Vanderkolk | Counselor | 928 S Garfield Ave Ste 3a, Traverse City, MI 49686-2403 | 2020-01-15 |
| 1801454459 | Anchor and Hope Counseling, LLC | Counselor | 2150 S Airport Rd W Ste C, Traverse City, MI 49684-4705 | 2019-05-30 |
| 1467809723 | Jakob Rossi | Counselor | 733 E 8th St Ste 204, Traverse City, MI 49686-2665 | 2016-05-17 |
| 1982079588 | Marsha Lynne Dallas | Counselor | 2240 South Airport Road, Traverse City, MI 49686 | 2015-12-08 |
| 1396155149 | Andra Williams | Counselor | 954 Business Park Dr, Suite 2, Traverse City, MI 49686-8763 | 2014-05-02 |
| 1922439835 | Tara Carroll | Counselor | 225 W 14th St, Traverse City, MI 49684-4037 | 2013-12-02 |
| 1033550363 | Emily Knapp | Counselor | 7150 Lake Leelanau Dr, Traverse City, MI 49684-9536 | 2013-07-15 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
Please comment or provide details below to improve the information on GERALD MICKETTI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.