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NPI Code Detail

MEDICARE: MS. MICHELLE D. TRASK M.S.W.

MEDICARE: MS. MICHELLE D. TRASK M.S.W.
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
11041C0700XClinical Social Worker9215SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609954528
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELLE D. TRASK M.S.W.
Provider Business Mailing Address
First Line : 223 S BONHAM RD
Second Line :
City : COLUMBIA
State : SC
Zip : 29205-4004
Country : US
Telephone Number : 803-404-2064
Fax Number :
Provider Business Practice Location Address
First Line : 1821 PICKENS ST
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-2630
Country : US
Telephone Number : 803-404-2064
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 10/05/2012

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