MEDICARE: CHRISTOPHER B MICHAELS 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	LG200001818	DC
2	104100000X	Social Worker	28286	MD

General Provider Information

NPI Number	:	1518651231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER B MICHAELS LMSW

Provider Business Mailing Address
First Line	:	12630 ROLLING RD
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20854-1963
Country	:	US
Telephone Number	:	323-448-5077
Fax Number	:

Provider Business Practice Location Address
First Line	:	10810 DARNESTOWN RD STE 103
Second Line	:
City	:	NORTH POTOMAC
State	:	MD
Zip	:	20878-2604
Country	:	US
Telephone Number	:	301-869-1017
Fax Number	:

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

Provider Enumeration Date	:	06/06/2023
Last Update Date	:	06/08/2023

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