Michelle Jefferson, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15346 Issued in MD

Practice address

511 W South St
Frederick, MD 21701-6241

Phone

(301) 696-1950

NPI assigned

Aug 15, 2013

Last updated

Aug 15, 2013By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bravo Psychological Group LLCGroup PAC ID 6800299496, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: michelle.jefferson.p1@direct.mcg-hhs.nextgenshare.com

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.

• Bravo Psychological Group, LLC

  • Clinical Psychologist
  • Gaithersburg, MD
  • NPI 1902475973

  DC

  Medicare reassignment Care Compare group NPD
• Advanced Behavioral Health, Inc

  dba ABH, Inc.

  • Clinic/Center
  • Frederick, MD
  • NPI 1154799559

  DC

  Medicare reassignment
• BPG Premiercare LLC

  • Mental Health Counselor
  • Gaithersburg, MD
  • NPI 1083480602
  NPD
• Crossroads Center of Frederick LLC

  • Community/Behavioral Health Agency
  • Frederick, MD
  • NPI 1083068563
  NPD (past)
• Crossroads Centers of Frederick

  • Community/Behavioral Health Agency
  • Frederick, MD
  • NPI 1568693562
  NPD (past)

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1316370182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 SHAWNEE DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 W SOUTH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016241",
            "telephone_number": "301-696-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "MICHELLE",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-15",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shyam Sundar Jayaraman, MD
• Jbot LLC
• Martine Jean-Baptiste
• Ruth Germain Jean-Pierre
• Jeanettes House LLC
• Jeffrey Cross DDS PA (Jeffrey Cross DDS)
• Jen-John Inc (DSF Cosmetic and Medical Dermatology)
• Angel Jenkins, LMSW
• Anne Louise Jenkins, LCSW-C
• Charles Lee Jenkins Jr., LCPC

• Clinical Social Worker in Frederick, MD
• Providers in Frederick, 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 Aug 15, 2013; 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.