Active NPI
Michelle Northam, LCSW-C
- Clinical Social Worker
- McKinney, TX
National Provider Identifier
1073913646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 109824
- Practice address
- 3600 El Dorado Parkway
McKinney, TX 75070 - Phone
- (240) 587-1256
- NPI assigned
- Sep 2, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Social Worker | 104100000X | 22028 | MD | |
| Clinical Social Worker | 1041C0700X | 109824 | TX | Primary |
Addresses
Primary practice location
3600 El Dorado Parkway
McKinney, TX 75070
Mailing address
3600 Eldorado Pkwy Ste 3
McKinney, TX 75070-3793
Phone (469) 545-3115
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22028 | MD | MD | Pharmacist |
| 109824 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717027200000",
"number": "1073913646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 ELDORADO PKWY STE 3",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750703793",
"telephone_number": "469-545-3115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 EL DORADO PARKWAY",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "75070",
"telephone_number": "240-587-1256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORTHAM",
"first_name": "MICHELLE",
"credential": "LCSW-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-02",
"last_updated": "2024-05-30",
"certification_date": "2024-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "22028",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "109824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McKinney, TX
- North Texas Orthopaedic & Spine, P.a.
- North Texas Pharmacy, LLC
- North Texas Sinus, P.a.
- North Texas Therapy Innovations, PC
- North Texas Transit Company
- Northpark Dental Associates
- Northtexas Center for Minimallyinvasive Gynecologic and Pelvic Surgery
- James Kent Norwood, D.D.S.
- John W. Norwood, DDS
- Ricardo Ignacio Nouel P.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.