Theodore Michener, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19774 Issued in MD

Practice address

903 Brightseat Rd
Landover, MD 20785-4725

Phone

(301) 333-2980

NPI assigned

May 15, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Optum Behavioral Care of North Carolina PCGroup PAC ID 5092120030, 175 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Optum Behavioral Care of North Carolina, PC

  • Counseling Psychologist
  • Columbia, MD
  • NPI 1518732833
  Medicare reassignment Care Compare group NPD
• Optum Behavioral Care of North Carolina, P.C.

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1861371718
  NPD

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1144886011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15518 N NEMO CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207161460",
            "telephone_number": "443-370-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 BRIGHTSEAT RD",
            "city": "LANDOVER",
            "state": "MD",
            "postal_code": "207854725",
            "telephone_number": "301-333-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHENER",
        "first_name": "THEODORE",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-15",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "19774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helene Mensah
• Cynthia Mercado-Saavedra
• Frewoin Meskele, DDS
• Allison Lynn Messinger
• Brenda Mewemdjo Koule
• Vatanya Middleton
• Susan Miles
• Daija A Miller
• Blaise Ngongban Mofor
• Nadine Monie

• Clinical Social Worker in Landover, MD
• Providers in Landover, 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 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.