MEDICARE: MS. MICHELE ROSE SARRIS MSW, LCSW-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	05707	MD

General Provider Information

NPI Number	:	1073958575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELE ROSE SARRIS MSW, LCSW-C

Provider Business Mailing Address
First Line	:	4402 BEL PRE RD
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20853-2030
Country	:	US
Telephone Number	:	240-595-4767
Fax Number	:

Provider Business Practice Location Address
First Line	:	4829 WEST LN
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-5317
Country	:	US
Telephone Number	:	240-595-4767
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2013
Last Update Date	:	05/09/2013

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