Active NPI
Michelle Lynn Willis, LMSW
- Social Worker
- Odenton, MD
National Provider Identifier
1780244582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 24862
- Practice address
- 1310 Saran CT
Odenton, MD 21113-1642 - Phone
- (410) 204-4092
- NPI assigned
- Jun 14, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 24862 | MD | Primary |
Addresses
Primary practice location
1310 Saran CT
Odenton, MD 21113-1642
Mailing address
1110 Benfield Blvd Ste B
Millersville, MD 21108-2644
Phone (410) 863-7213
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24862 | MD | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metaphorward Therapy, LLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Odenton, MD
- NPI 1609570357
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698105600000",
"number": "1780244582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 BENFIELD BLVD STE B",
"city": "MILLERSVILLE",
"state": "MD",
"postal_code": "211082644",
"telephone_number": "410-863-7213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 SARAN CT",
"city": "ODENTON",
"state": "MD",
"postal_code": "211131642",
"telephone_number": "410-204-4092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "MICHELLE",
"middle_name": "LYNN",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-14",
"last_updated": "2023-10-24",
"certification_date": "2023-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "24862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Odenton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.