Individual provider Active NPI

Michelle Faye Ross, LCSW

  • Clinical Social Worker
  • Coral Springs, FL
National Provider Identifier
1336396175
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW5123 Issued in FL
Practice address
1515 N University Dr
Suite 102a
Coral Springs, FL 33071-6096
Phone
(954) 512-8374
Fax
(954) 341-8945
NPI assigned
Aug 22, 2008
Last updated
Dec 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CAP 2392 FL
Clinical Social Worker 1041C0700X SW5123 FL Primary

Addresses

Primary practice location

1515 N University Dr
Suite 102a
Coral Springs, FL 33071-6096

Mailing address

1515 N University Dr
Suite 102a
Coral Springs, FL 33071-6096
Phone (954) 512-8374

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20090709000146 FL Practitioner - Clinical Social Worker 0042362881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1515 N University Dr
102A
Coral Springs, FL 33071-6083
Phone (954) 512-8374

1515 University Dr
Suite 102a
Coral Springs, FL 33071-6083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CAP 2392FLMDAddiction (Substance Use Disorder) Counselor
SW5123FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Michelle Ross PA Clinical CurrentSince Apr 26, 2009 Accepting new patients

Locations

1515 N University Dr
Ste 102A
Coral Springs, FL 33071
Phone (718) 872-8456

Networks

  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1336396175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N UNIVERSITY DR",
            "address_2": "SUITE 102A",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330716096",
            "telephone_number": "954-512-8374",
            "fax_number": "954-341-8945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N UNIVERSITY DR",
            "address_2": "SUITE 102A",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330716096",
            "telephone_number": "954-512-8374",
            "fax_number": "954-341-8945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "MICHELLE",
        "middle_name": "FAYE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-22",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "CAP 2392",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.