Provider Demographics
NPI:1730072380
Name:COGAR, MICHELLE WRIGHT (LMSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:WRIGHT
Last Name:COGAR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 KOSOAK RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2300
Mailing Address - Country:US
Mailing Address - Phone:443-986-3057
Mailing Address - Fax:
Practice Address - Street 1:135 N PARKE ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-2428
Practice Address - Country:US
Practice Address - Phone:443-625-1600
Practice Address - Fax:410-272-3306
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD33254101YM0800X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health