Individual provider Active NPI

Karen J Micka, LPCC

  • Professional Counselor
  • Dayton, OH
National Provider Identifier
1053733402
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E0002658 Issued in OH
Practice address
601 S Edwin C Moses Blvd
Dayton, OH 45417-3424
Phone
(937) 734-8333
Fax
(937) 299-3040
NPI assigned
Jan 19, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E0002658 OH Primary

Addresses

Primary practice location

601 S Edwin C Moses Blvd
Dayton, OH 45417-3424

Mailing address

601 S Edwin Moses Blvd
Dayton, OH 45417-3424
Phone (937) 734-8333

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
E0002658OHMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1390089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1053733402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S EDWIN MOSES BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-734-8333",
            "fax_number": "937-299-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S EDWIN C MOSES BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173424",
            "telephone_number": "937-734-8333",
            "fax_number": "937-299-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKA",
        "first_name": "KAREN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-19",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0002658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; 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.