MEDICARE: MICHELLE QUETZALY ELIAS LMSW

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	104100000X	Social Worker	33681	MD

General Provider Information

NPI Number	:	1972459295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE QUETZALY ELIAS LMSW

Provider Business Mailing Address
First Line	:	11237 MINSTREL TUNE DR
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20876-6306
Country	:	US
Telephone Number	:	240-550-9720
Fax Number	:	240-306-1104

Provider Business Practice Location Address
First Line	:	19707 EXECUTIVE PARK CIR
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20874-2639
Country	:	US
Telephone Number	:	240-550-9720
Fax Number	:

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

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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