Individual provider Active NPI

Michelle D. Trask, M.S.W.

  • Clinical Social Worker
  • Columbia, SC
National Provider Identifier
1609954528
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9215 Issued in SC
Practice address
1821 Pickens St
Columbia, SC 29201-2630
Phone
(803) 404-2064
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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 9215 SC Primary

Addresses

Primary practice location

1821 Pickens St
Columbia, SC 29201-2630

Mailing address

223 S Bonham Rd
Columbia, SC 29205-4004
Phone (803) 404-2064

Other identifiers 1

IdentifierTypeStateIssuer
011543600MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20121107000027 SC Practitioner - Clinical Social Worker 2961653621 Practice locations: Columbia, SC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1821 Pickens St
Columbia, SC 29201-2630
Phone (803) 404-2064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1609954528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 S BONHAM RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292054004",
            "telephone_number": "803-404-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 PICKENS ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012630",
            "telephone_number": "803-404-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRASK",
        "first_name": "MICHELLE",
        "middle_name": "D.",
        "name_prefix": "Ms.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "9215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011543600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.