Organization Active NPI

Shake the Dust Therapy, LLC

  • Clinical Social Worker
  • Germantown, MD
National Provider Identifier
1609575612
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SHAKE THE DUST THERAPY, LLC
Practice address
11509 Sir Spencer Way
Germantown, MD 20876-5446
Phone
(301) 717-8124
NPI assigned
Feb 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Authorized official

Name
Michele Arora, LCSW-CNPI 1649827148
Title
Resident Agent
Phone
(240) 813-0511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

11509 Sir Spencer Way
Germantown, MD 20876-5446

Mailing address

267 Kentlands Blvd
Gaithersburg, MD 20878-5446

National Provider Directory

National Provider Directory
Tax ID family
Shake the Dust Therapy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1609575612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 KENTLANDS BLVD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208785446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11509 SIR SPENCER WAY",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208765446",
            "telephone_number": "301-717-8124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAKE THE DUST THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-28",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "ARORA",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "RESIDENT AGENT",
        "authorized_official_telephone_number": "240-813-0511",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.