Michael Patrick Wall, LCSWC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSWC07449 Issued in MD

Practice address

692 Ritchie Hwy
Suite 203
Severna Park, MD 21146-3919

Phone

(410) 647-4862

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063552586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 DUNGARRIE RD",
            "city": "BALTO",
            "state": "MD",
            "postal_code": "212283401",
            "telephone_number": "410-382-2859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "692 RITCHIE HWY",
            "address_2": "SUITE 203",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463919",
            "telephone_number": "410-647-4862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "LCSWC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "LCSWC07449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MD",
            "identifier": "1QV10MP2752664001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lydia E Wainwright, M.AC., L.AC., C.A.A.
• Walgreen Co
• Walgreen Co
• Walgreen Co.
• Mary Walker
• Madeline Ward
• Kylie Waterman
• Joan M Watt, PA-C
• Edward Charles Watters III, M.D.
• Waves of Wellness Studio LLC

• Clinical Social Worker in Severna Park, MD
• Providers in Severna Park, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.