Individual provider Active NPI

Michelle D Logan, LMSW

  • Social Worker
  • Frederick, MD
National Provider Identifier
1063992246
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
23899 Issued in MD
Practice address
1003 W Seventh St Ste 500
Frederick, MD 21701-8512
Phone
(301) 345-1022
Fax
(301) 560-5558
NPI assigned
Aug 17, 2018
Last updated
Aug 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 23899 MD Primary

Addresses

Primary practice location

1003 W Seventh St Ste 500
Frederick, MD 21701-8512

Mailing address

7474 Greenway Center Dr Ste 730
Greenbelt, MD 20770-3523
Phone (301) 345-1022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20221111000241 MD Practitioner - Clinical Social Worker 8123495710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Behavioral Health IncGroup PAC ID 8022147933, 26 clinicians

Practice addresses (Care Compare)

1003 W 7TH St
Suite 500
Frederick, MD 21701-8512
Phone (301) 345-1022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23899MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Behavioral Health, Inc CurrentSince Oct 7, 2022 Accepting new patients

Locations

5820 York Rd
Ste 202
Baltimore, MD 21212
Phone (301) 345-7012

1003 W 7th St
Ste 500
Frederick, MD 21701
Phone (240) 297-1567

7474 Greenway Center Dr
Ste 730
Greenbelt, MD 20770
Phone (301) 982-3437

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1063992246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7474 GREENWAY CENTER DR STE 730",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703523",
            "telephone_number": "301-345-1022",
            "fax_number": "301-560-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 W SEVENTH ST STE 500",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217018512",
            "telephone_number": "301-345-1022",
            "fax_number": "301-560-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "MICHELLE",
        "middle_name": "D",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "23899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.