Individual provider Active NPI

Michelle Jones

  • Clinical Social Worker
  • Erie, PA
National Provider Identifier
1861947764
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW018918 Issued in PA
Practice address
823 Filmore Ave
Erie, PA 16505-4127
Phone
(814) 580-9167
NPI assigned
Aug 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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 CW018918 PA Primary

Addresses

Primary practice location

823 Filmore Ave
Erie, PA 16505-4127

Mailing address

823 Filmore Ave
Erie, PA 16505-4127
Phone (607) 423-4604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 22, 2020 through May 22, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CW018918PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Life Balance Counseling and Wellness, LLC CurrentSince Feb 5, 2024 Accepting new patients

Locations

823 Filmore Ave
Erie, PA 16505
Phone (814) 273-9773

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.

NPI Registry JSON

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

{
    "created_epoch": "1471651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1861947764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 FILMORE AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165054127",
            "telephone_number": "607-423-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 FILMORE AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165054127",
            "telephone_number": "814-580-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-20",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.