Provider Demographics
NPI:1962671362
Name:SHAY, MICHELLE B (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:B
Last Name:SHAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9426 STEWARTOWN RD
Mailing Address - Street 2:2F
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-1601
Mailing Address - Country:US
Mailing Address - Phone:301-208-8900
Mailing Address - Fax:301-208-8369
Practice Address - Street 1:9426 STEWARTOWN RD
Practice Address - Street 2:2F
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-1601
Practice Address - Country:US
Practice Address - Phone:301-208-8900
Practice Address - Fax:301-208-8369
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD124691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical