Individual provider Active NPI

Michele D Ruetsch, LCSW-C

  • Clinical Social Worker
  • Ellicott City, MD
National Provider Identifier
1831757517
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16221 Issued in MD
Practice address
8165 Cyprus Cedar LN Ste 102
Ellicott City, MD 21043-5559
Phone
(443) 286-6719
NPI assigned
May 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2019

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 16221 MD Primary

Addresses

Primary practice location

8165 Cyprus Cedar LN Ste 102
Ellicott City, MD 21043-5559

Mailing address

8165 Cyprus Cedar LN Ste 102
Ellicott City, MD 21043-5559
Phone (443) 286-6719

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

LicenseStateTypeSpecialty
16221MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1831757517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8165 CYPRUS CEDAR LN STE 102",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210435559",
            "telephone_number": "443-286-6719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8165 CYPRUS CEDAR LN STE 102",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210435559",
            "telephone_number": "443-286-6719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUETSCH",
        "first_name": "MICHELE",
        "middle_name": "D",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "16221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.