Individual provider Active NPI

Michelle McDonald, PHD

  • Clinical Psychologist
  • Leonardtown, MD
National Provider Identifier
1417494469
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
07467 Issued in MD
Practice address
40900 Merchants LN Unit 207
Leonardtown, MD 20650-3796
Phone
(518) 369-5282
Fax
(301) 560-4954
NPI assigned
Jan 30, 2017
Last updated
Dec 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY9795 FL
Clinical Psychologist 103TC0700X 07467 MD Primary

Addresses

Primary practice location

40900 Merchants LN Unit 207
Leonardtown, MD 20650-3796

Mailing address

40900 Merchants LN Unit 207
Leonardtown, MD 20650-3796
Phone (518) 369-5282

Other names 1

  • Michelle Moshier Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251027001954 MD Practitioner - Clinical Psychologist 3971888298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

24351 Mervell Dean Rd
Unit 382
Hollywood, MD 20636-7518

24351 Mervell Dean Rd
Unit 382
Hollywood, MD 20636-9998

590 N Kimball Ave
Suite 100
Southlake, TX 76092-6878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY9795FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Behavioral Health, LLC Psychologist CurrentSince Jul 10, 2022 Accepting new patients
Southern Baptist Hospital of Florida Inc Past Accepting new patients

Locations

1650 Prudential Dr
Ste 210
Jacksonville, FL 32207
Phone (904) 376-3755

Organizations & group practices 3

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": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1417494469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40900 MERCHANTS LN UNIT 207",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206503796",
            "telephone_number": "518-369-5282",
            "fax_number": "301-560-4954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40900 MERCHANTS LN UNIT 207",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206503796",
            "telephone_number": "518-369-5282",
            "fax_number": "301-560-4954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "MICHELLE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-30",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY9795",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "07467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "MOSHIER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leonardtown, MD

Sources for this page

Verify at the official NPI Registry.