Michelle Roque, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

25703 Issued in MD

Practice address

9015 Woodyard Rd
Clinton, MD 20735-4209

Phone

(240) 244-2924

NPI assigned

Apr 9, 2024

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

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 and National Provider Directory roles.

• Changing Lives Adult & Youth Services

  • Community/Behavioral Health Agency
  • Clinton, MD
  • NPI 1609320340
  NPD

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1326891383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9015 WOODYARD RD STE 109",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354226",
            "telephone_number": "240-244-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9015 WOODYARD RD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354209",
            "telephone_number": "240-244-2924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROQUE",
        "first_name": "MICHELLE",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "25703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rivers Dermatology, LLC
• James Curtis Roberson II, M.D.
• Mychael Robinson
• Jacqueline N Rogers, LCPC
• Hector Andres Rojas Martinez
• Rosemond Dickson Bartels CRNP LLC
• Rosemond Dickson Bartels, CRNP, LLC
• Bryan Rosenberg
• Jefferey Dennis Sabloff, MD
• Bita Sadeghlo, DDS

• Clinical Social Worker in Clinton, MD
• Providers in Clinton, 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 Apr 9, 2024; 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.