Individual provider Active NPI

Michele Root, LCSW

  • Clinical Social Worker
  • Sacramento, CA
National Provider Identifier
1487276176
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
121718 Issued in CA
Practice address
2108 N St # 9254
Sacramento, CA 95816-5712
Phone
(408) 320-5377
NPI assigned
May 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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 121718 CA Primary

Addresses

Primary practice location

2108 N St # 9254
Sacramento, CA 95816-5712

Mailing address

PO Box 390852
Mountain View, CA 94039-0852
Phone (408) 320-5377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 18, 2025 through Jun 18, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
121718CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mr Therapy, a Licensed Clinical Social Worker Professional Corporation Clinical CurrentSince Oct 6, 2024 Accepting new patients

Locations

2108 N St
Sacramento, CA 95816
Phone (951) 719-7050

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": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1487276176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 390852",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940390852",
            "telephone_number": "408-320-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 N ST # 9254",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165712",
            "telephone_number": "408-320-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT",
        "first_name": "MICHELE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "121718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.