Look up the most recent NPI and PECOS records

Michelle Laura Maddex

Social Worker

Behavioral Health & Social Service Providers

PECOS Enrollment

This provider is enrolled in PECOS as MICHELLE MADDEX.

Based on the most recent information from CMS, provider Michelle Laura Maddex is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 12:07 PM.

Profile Details

Provider ID
1952823551
Provider Type
Individual
Full Name
Maddex, Michelle Laura
Credential
LICSW

Gender
Female
Sole Proprietor
No
Enumeration Date
7/14/2017
Last Updated
1/9/2023

Contact Information

Practice Location

45 Dimock St, Roxbury, MA 02119-1208

(617) 442-8800

(617) 541-5472

Mailing Location

240 Shotwell St, San Francisco, CA 94110-1323

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 125585 Massachusetts
Code 1041C0700X	Description Social Worker Behavioral Health & Social Service Providers	License ASW77284 California

Michelle Laura Maddex

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Butler, Lauren Marie

Chandler, Danielle Adrienne

Shotkin, Rachel

Ramirez, Amanda Elizabeth

Siegel, Michelle A

Dowling, Janine

Correia, Ashley

Clifford, Meaghan

Santos, Stephen

Durgin, Emily