Michelle Katherine Priddy, LCPC, ATC/LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A0000014 Issued in MD

Practice address

125 Ruthsburg Rd.
Centreville, MD 21617

Phone

(410) 829-8588

NPI assigned

Apr 3, 2015

Last updated

Jan 27, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rising Hope Christian Counseling and Wellness, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Centreville, MD
  • NPI 1528729977
  NPD Authorized official

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1881089084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6190 ROCK HALL RD",
            "city": "ROCK HALL",
            "state": "MD",
            "postal_code": "216612007",
            "telephone_number": "410-739-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 RUTHSBURG RD.",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "21617",
            "telephone_number": "410-829-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDDY",
        "first_name": "MICHELLE",
        "middle_name": "KATHERINE",
        "credential": "LCPC, ATC/LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-03",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC9108",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": "A0000014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Jo Paulson, MSPT, DPT
• Rebecca Perry
• Christine Pitchford, PT
• Laura Bazzell Porter, COTA
• Nancy L Price, P.T.
• Project Chesapeake, LLC
• Project Chesapeake, LLC
• Project Chesapeake, LLC
• Project Chesapeake, LLC
• Queen Anne's County Board of Education

• Athletic Trainer in Centreville, MD
• Providers in Centreville, MD by specialty
• Athletic Trainer in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.