Michaelle Andre
Individual provider Active NPI Mental Health Counselor · Riverdale, MD
NPI 1770144875 · NPPES record last updated Feb 23, 2022
Key facts
- NPI
- 1770144875
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LGP12324 (MD)
- Practice address
- 4808 Tuckerman St
Riverdale, MD 20737-1145 - Phone
- (240) 528-1534
- NPI assigned
- Jun 28, 2019
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| LGP12324 | MD | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Mental Health Counselor | 101YM0800X | LGP12324 | MD | Yes |
Addresses
Primary practice location
4808 Tuckerman St
Riverdale, MD 20737-1145
Mailing address
4808 Tuckerman St
Riverdale, MD 20737-1145
Phone (240) 528-1534
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All providers in Riverdale, MD · Mental Health Counselor in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.