MEDICARE: MS. MICHELLE ANTOINETTE PIACQUADIO LCSW

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	0904001191	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	C01884	OTHER	MCARE GROUP
2	253774	OTHER	ANTHEM PPO BCBS
3	066469	OTHER	MAGELLAN
4	018485	OTHER	VALUE OPTIONS
5	084060	OTHER	SENTARA OPTIMA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	17011	OTHER	CIGNA
8	P00035376	OTHER	MCARE RAILROAD
9	241248	OTHER	MANAGED HEALTH NETWORK

General Provider Information

NPI Number	:	1447223797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE ANTOINETTE PIACQUADIO LCSW

Provider Business Mailing Address
First Line	:	3409 WHITE FIR CT UNIT D
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20602-3609
Country	:	US
Telephone Number	:	757-581-7639
Fax Number	:

Provider Business Practice Location Address
First Line	:	1050 W PERIMETER RD
Second Line	:	JOINT BASE ANDREWS AFB
City	:	ANDREWS AIR FORCE BASE
State	:	MD
Zip	:	20762-6601
Country	:	US
Telephone Number	:	240-857-8684
Fax Number	:

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	03/28/2013

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Directions to “ MS. MICHELLE ANTOINETTE PIACQUADIO LCSW” Practice Location

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