Provider Demographics
NPI:1053087429
Name:BAKALARSKI, MICHELLE LEE (MA, LMFT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEE
Last Name:BAKALARSKI
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7960 SOQUEL DR STE B393
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-3999
Mailing Address - Country:US
Mailing Address - Phone:312-505-6541
Mailing Address - Fax:
Practice Address - Street 1:2425 PORTER ST
Practice Address - Street 2:
Practice Address - City:SOQUEL
Practice Address - State:CA
Practice Address - Zip Code:95073-2444
Practice Address - Country:US
Practice Address - Phone:831-251-4922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-17
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool