MEDICARE: MS. MICHELLE M SALOIS LCSW

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	140-010352	IL
2	1041C0700X	Clinical Social Worker	002117	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6280365	OTHER	MO	UBH CLAIMS
2	000604312SAL	OTHER	MO	MERCY HEALTH PLANS
3	155294	OTHER	MO	BLUE CROSS/ BLUE SHIELD
4	A4004610	OTHER	MO	VALUE BEHAVIORAL HEALTH R
5	SALO3613	OTHER	MO	CAQH
6	155294	OTHER	MO	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1770509960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE M SALOIS LCSW

Provider Business Mailing Address
First Line	:	2609 ABBOTT PL
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63143-2609
Country	:	US
Telephone Number	:	314-993-8818
Fax Number	:	314-983-0331

Provider Business Practice Location Address
First Line	:	7200 MANCHESTER RD
Second Line	:
City	:	MAPLEWOOD
State	:	MO
Zip	:	63143-2403
Country	:	US
Telephone Number	:	314-993-8818
Fax Number	:

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	05/15/2024

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