Michelle Ann Ensrud Lam, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904010770 Issued in VA

Practice address

4460 Brookfield Corporate Dr Ste H
Chantilly, VA 20151-1671

Phone

(571) 933-8151

Fax

(571) 933-8438

NPI assigned

Nov 7, 2018

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 names 1

• Ms. Michelle Ann Lam Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1255809240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 KINFOLK CT",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201714011",
            "telephone_number": "540-220-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 BROOKFIELD CORPORATE DR STE H",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511671",
            "telephone_number": "571-933-8151",
            "fax_number": "571-933-8438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "MICHELLE",
        "middle_name": "ANN ENSRUD",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "LAM",
            "middle_name": "ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ladderbox, LLC
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• Bess Lam, BCBA
• Emily Lam
• Julia Lam, OD
• Vivian Lam
• Lina Lamantia, M.ADS, BCBA
• Karen J Lamberton, MSN, ARNP, FNP-BC
• James Landzinski, PHARMD.
• Davina Yvonne Lane

• Clinical Social Worker in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.