MEDICARE: MICHELLE POYE-SEAL 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	18724	MD

General Provider Information

NPI Number	:	1316293780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE POYE-SEAL LCSW-C

Provider Business Mailing Address
First Line	:	21629 NATIONAL PIKE
Second Line	:
City	:	BOONSBORO
State	:	MD
Zip	:	21713-1638
Country	:	US
Telephone Number	:	301-305-1740
Fax Number	:	301-668-1910

Provider Business Practice Location Address
First Line	:	138 W WASHINGTON ST
Second Line	:
City	:	HAGERSTOWN
State	:	MD
Zip	:	21740-4734
Country	:	US
Telephone Number	:	301-305-1740
Fax Number	:	301-733-2432

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

Provider Enumeration Date	:	08/03/2012
Last Update Date	:	02/27/2017

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