Individual provider Active NPI

Michelle Anderson, LCSW-C

  • Clinical Social Worker
  • Gaithersburg, MD
National Provider Identifier
1831700871
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22881 Issued in MD
Practice address
12 S Summit Ave Ste 100
Gaithersburg, MD 20877-2090
Phone
(352) 281-9919
NPI assigned
Aug 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2025

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 22881 MD Primary

Addresses

Primary practice location

12 S Summit Ave Ste 100
Gaithersburg, MD 20877-2090

Mailing address

12 S Summit Ave Ste 100
Gaithersburg, MD 20877-2090
Phone (352) 281-9919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 9, 2021 through Nov 9, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22881MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1831700871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 S SUMMIT AVE STE 100",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772090",
            "telephone_number": "352-281-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 S SUMMIT AVE STE 100",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772090",
            "telephone_number": "352-281-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MICHELLE",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "22881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.