| Doctor Name: | MRS. MICHELLE RENEE FORAKER |
| NPI Number: | 1639258874 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MAED, LPCC-S |
| License Number: | E0500227 |
| Business Practice Address: | 1201 S Main St Ste 100 North Canton, OH - 447204283 |
| Business Phone Number: | 3302448782 |
| Business Fax Number: | 3302448795 |
| Mailing Address: | 1201 S Main St Ste 100, NORTH CANTON |
| State: | OH |
| Postal Code: | 447204283 |
| Phone Number: | 3302448782 |
| Fax Number: | 3302448795 |
| NPI Enumeration Date: | 11/06/2006 |
| NPI Last Update Date: | 02/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | E0500227 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |