Individual provider Active NPI

Michael D Schell-Smith, LCSW

  • Clinical Social Worker
  • Fredericksburg, VA
National Provider Identifier
1720165129
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904001812 Issued in VA
Practice address
601 Jefferson Davis Hwy Ste 101
Fredericksburg, VA 22401-4564
Phone
(703) 490-0336
Fax
(703) 490-0336
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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 0904001812 VA Primary

Addresses

Primary practice location

601 Jefferson Davis Hwy Ste 101
Fredericksburg, VA 22401-4564

Mailing address

7969 Ashton Ave
Manassas, VA 20109-2885
Phone (703) 792-7800

Other identifiers 4

IdentifierTypeStateIssuer
4945247MedicaidVA
292895OtherVAAMERIGROUP
210307OtherVABLUE CROSS BLUE SHIELD
5460015431OtherVAEIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20050216000739 VA Practitioner - Clinical Social Worker 7113979253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychological and Life Skills Associates PCGroup PAC ID 4688661838, 8 clinicians

Practice addresses (Care Compare)

13885 Hedgewood Dr
Woodbridge, VA 22193-7931
Phone (703) 490-0336

601 Emancipation Hwy
Suite 101
Fredericksburg, VA 22401-4564
Phone (703) 490-0336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological and Life Skills Associates, P.C. CurrentSince Dec 5, 2008 Accepting new patients
Prince William County Past Accepting new patients
Prince William County Community Services Board PastSince Feb 1, 2026 Accepting new patients
Psychological and Life Skills Association Clinical PastSince Sep 6, 2020 Accepting new patients

Locations

13885 Hedgewood Dr
Ste 245
Woodbridge, VA 22193
Phone (703) 490-0336

Organizations & group practices 4

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1720165129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7969 ASHTON AVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092885",
            "telephone_number": "703-792-7800",
            "fax_number": "703-792-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JEFFERSON DAVIS HWY STE 101",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014564",
            "telephone_number": "703-490-0336",
            "fax_number": "703-490-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHELL-SMITH",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904001812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4945247",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "292895",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "210307",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EIN",
            "identifier": "5460015431",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.