Michelle Ann Taylor, LMSW

Individual provider Active NPI Clinical Social Worker · Jefferson, MD

NPI 1669942892 · NPPES record last updated Nov 30, 2018

Key facts

NPI
1669942892
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
G08031 (MD)
Practice address
Breakthrough Counseling Services
4014 Mountville Road
Jefferson, MD 21755-7713
Phone
(240) 986-1001
NPI assigned
Nov 30, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
G08031MDMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X G08031 MD Yes

Addresses

Primary practice location

Breakthrough Counseling Services
4014 Mountville Road
Jefferson, MD 21755-7713

Mailing address

11718 Scarlet Leaf Cir
Germantown, MD 20876-6049
Phone (301) 503-2854

Other providers in Jefferson, MD

All providers in Jefferson, MD · Clinical Social Worker in Maryland

Sources for this page

Verify at the official NPI Registry.