Michelle Srader, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

59384 Issued in TX

Practice address

105 Canyon Lake Cir
Lumberton, TX 77657-3701

Phone

(409) 200-2220

Fax

(409) 440-3344

NPI assigned

Aug 15, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1689073629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CANYON LAKE CIR",
            "city": "LUMBERTON",
            "state": "TX",
            "postal_code": "776573701",
            "telephone_number": "409-200-2220",
            "fax_number": "409-440-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CANYON LAKE CIR",
            "city": "LUMBERTON",
            "state": "TX",
            "postal_code": "776573701",
            "telephone_number": "409-200-2220",
            "fax_number": "409-440-3344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6495 Woodridge Dr",
            "address_purpose": "LOCATION",
            "city": "Lumberton",
            "state": "TX",
            "postal_code": "776578209",
            "country_code": "US",
            "telephone_number": "409-221-1656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4749 Odom Rd",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777067080",
            "country_code": "US",
            "telephone_number": "409-200-2220",
            "fax_number": "409-440-3344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SRADER",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "59384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Lumberton, TX
• Providers in Lumberton, TX by specialty
• Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; 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.