Individual provider Active NPI

Michelle Guy Debord, LCSW

  • Clinical Social Worker
  • Marion, VA
National Provider Identifier
1316052657
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904006384 Issued in VA
Practice address
434 Mitchell Valley Dr
Marion, VA 24354-6338
Phone
(276) 783-7600
Fax
(276) 783-1802
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904006384 VA Primary

Addresses

Primary practice location

434 Mitchell Valley Dr
Marion, VA 24354-6338

Mailing address

434 Mitchell Valley Dr
Marion, VA 24354-6338
Phone (276) 783-7600

Other identifiers 4

IdentifierTypeStateIssuer
1316052657OtherVANPI
004945298MedicaidVA
0904006384OtherVALICENSE
13583210OtherVACAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20151002001213 VA Practitioner - Clinical Social Worker 2163730664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heatherwood Counseling Center IncGroup PAC ID 9133100605, 11 clinicians

Practice addresses (Care Compare)

434 Mitchell Valley Dr
Marion, VA 24354-6338
Phone (276) 783-7600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heatherwood Counseling Center, Inc. Clinical CurrentSince Sep 1, 2015 Accepting new patients

Locations

434 Mitchell Valley Dr
Marion, VA 24354
Phone (276) 783-7600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1316052657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 MITCHELL VALLEY DR",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243546338",
            "telephone_number": "276-783-7600",
            "fax_number": "276-783-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 MITCHELL VALLEY DR",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243546338",
            "telephone_number": "276-783-7600",
            "fax_number": "276-783-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBORD",
        "first_name": "MICHELLE",
        "middle_name": "GUY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904006384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1316052657",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945298",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0904006384",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13583210",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, VA

Sources for this page

Verify at the official NPI Registry.