Michelle Dattada, LCSW, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C007061 Issued in NC

Legal business name

MICHELLE DATTADA, LCSW, PLLC

Practice address

992 Durham Rd Ste a
Wake Forest, NC 27587-6590

Phone

(732) 485-3956

NPI assigned

May 15, 2012

Last updated

May 15, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Michelle Ann Dattada, LCSW

Title

Owner

Phone

(732) 485-3956

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337040000000",
    "number": "1134488836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 LAGERFELD WAY",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "27587",
            "telephone_number": "732-485-3956",
            "fax_number": "919-457-0174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 DURHAM RD STE A",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876590",
            "telephone_number": "732-485-3956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE DATTADA, LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-15",
        "last_updated": "2012-05-15",
        "status": "A",
        "authorized_official_last_name": "DATTADA",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-485-3956",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Albert Augustine Meyer III, PT, DPT
• Alyson Elizabeth Meyer, PHARMD
• Gina Louise Micchia, DO
• Joseph Matthew Micchia Jr., DO
• Michael C. Kretchmer DDS, Ms, PA II (Tar Heel Periodontics and Implant Dentistry)
• Sola E Miles, M.H.S, PA-C
• Milestones Counseling, PLLC
• Adrian Miller
• Madalyn Miller
• Thomas R Miller Jr., OD

• Clinical Social Worker in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; 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.