Individual provider Active NPI

Michelle Sham, MSW, LICSW

  • Clinical Social Worker
  • Roslindale, MA
National Provider Identifier
1023370616
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
127686 Issued in MA
Practice address
780 American Legion Hwy
Roslindale, MA 02131-3908
Phone
(857) 208-0975
Fax
(617) 469-8660
NPI assigned
Jun 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 127686 MA Primary

Addresses

Primary practice location

780 American Legion Hwy
Roslindale, MA 02131-3908

Mailing address

780 American Legion Hwy
Roslindale, MA 02131-3908
Phone (857) 208-0975

Other practice location 1

1493 Cambridge St
Cambridge, MA 02139-1099
Phone (617) 665-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251223002532 MA Practitioner - Clinical Social Worker 3971098385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1493 Cambridge St
Cambridge, MA 02139-1099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
127686MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission Current Accepting new patients
Cambridge Public Health Commission CurrentSince Oct 14, 2025 Accepting new patients
Cambridge Public Health Commission CurrentSince Oct 14, 2025 Accepting new patients

Locations

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

350 Main St
Ste 31
Malden, MA 02148
Phone (781) 397-6583

Interoperability endpoints

  • Direct secure messaging: msham121123@direct.challiance.masshiway.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1023370616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 AMERICAN LEGION HWY",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021313908",
            "telephone_number": "857-208-0975",
            "fax_number": "617-469-8660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 AMERICAN LEGION HWY",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021313908",
            "telephone_number": "857-208-0975",
            "fax_number": "617-469-8660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1493 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021391099",
            "country_code": "US",
            "telephone_number": "617-665-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAM",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "127686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslindale, MA

Sources for this page

Verify at the official NPI Registry.