Healthcare Provider Details

I. General information

NPI: 1003639097
Provider Name (Legal Business Name): MICHELLE CAMARDI MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2024
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5673 AIRPORT RD NW
ROANOKE VA
24012-1119
US

IV. Provider business mailing address

637 DAY AVE SW UNIT B
ROANOKE VA
24016-3817
US

V. Phone/Fax

Practice location:
  • Phone: 540-523-8099
  • Fax:
Mailing address:
  • Phone: 540-588-5084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904013444
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: