Individual provider Active NPI

Evan Thomas Mikulka, CDCA. 192321

  • Addiction (Substance Use Disorder) Counselor
  • Austintown, OH
National Provider Identifier
1003604901
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.192321 Issued in OH
Practice address
45 N Canfield Niles Rd
Austintown, OH 44515-2343
Phone
(330) 642-8242
NPI assigned
Apr 29, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.192321 OH Primary

Addresses

Primary practice location

45 N Canfield Niles Rd
Austintown, OH 44515-2343

Mailing address

45 N Canfield Niles Rd
Austintown, OH 44515-2343
Phone (330) 642-8242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CDCA.192321OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1745884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1003604901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 N CANFIELD NILES RD",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445152343",
            "telephone_number": "330-642-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 N CANFIELD NILES RD",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445152343",
            "telephone_number": "330-642-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKULKA",
        "first_name": "EVAN",
        "middle_name": "THOMAS",
        "credential": "CDCA. 192321",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-29",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.192321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austintown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.