Provider Demographics
NPI:1548867104
Name:DUSS, MICHELE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:
Last Name:DUSS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:DECAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6254 ALHAMBRA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34291-5918
Mailing Address - Country:US
Mailing Address - Phone:813-767-7879
Mailing Address - Fax:
Practice Address - Street 1:4620 17TH ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34235-1843
Practice Address - Country:US
Practice Address - Phone:941-371-8820
Practice Address - Fax:941-377-3194
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW172941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical