Michelle L Kosa, MSW, LGSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

BP00941890 Issued in WV

Practice address

97 Great Teays Blvd
Suite 6
Scott Depot, WV 25560-9815

Phone

(304) 757-6999

Fax

(304) 201-5019

NPI assigned

Apr 27, 2016

Sex

Female

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

Enrolled in WV

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1194170191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 GREAT TEAYS BLVD",
            "address_2": "SUITE 6",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255609815",
            "telephone_number": "304-757-6999",
            "fax_number": "304-201-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 GREAT TEAYS BLVD",
            "address_2": "SUITE 6",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255609815",
            "telephone_number": "304-757-6999",
            "fax_number": "304-201-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSA",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "MSW, LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "BP00941890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194170191",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Scott Depot, WV
• Providers in Scott Depot, WV by specialty
• Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.