Michelle Dague, LCSW, QMHP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L5319 Issued in OR

Practice address

777 NE 7TH St Ste 208
Grants Pass, OR 97526-1632

Phone

(503) 884-3946

Fax

(503) 200-1302

NPI assigned

Jan 27, 2009

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Michelle Dague LCSW Professional Corporation

  • Clinical Social Worker
  • Grants Pass, OR
  • NPI 1053991257
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1233014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1740428853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 445",
            "city": "MURPHY",
            "state": "OR",
            "postal_code": "975330445",
            "telephone_number": "503-884-3946",
            "fax_number": "503-200-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 NE 7TH ST STE 208",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261632",
            "telephone_number": "503-884-3946",
            "fax_number": "503-200-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGUE",
        "first_name": "MICHELLE",
        "credential": "LCSW, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-27",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L5319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500800774",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Lee Curtis
• Judith Czerniak
• Brian E Dadisman
• Matthew Dagata, PSS
• Jessica Nicole Daggett, DOULA, CBED
• Dennis Dale, RN
• Shawnee Elsa Dale, BS
• Quchyal Lei Dance, LMT
• Daniel Dirk
• Daniel L Moline, MD, PC

• Clinical Social Worker in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.