Individual provider Active NPI

Gina Marie Mikolawski-Aguinaga, LCSW

  • Clinical Social Worker
  • Lakeland, FL
National Provider Identifier
1083825681
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW6978 Issued in FL
Practice address
500 S Florida Ave
# 210
Lakeland, FL 33801-5276
Phone
(863) 687-1222
Fax
(863) 603-6546
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW6978 FL Primary

Addresses

Primary practice location

500 S Florida Ave
# 210
Lakeland, FL 33801-5276

Mailing address

PO Box 102101
Atlanta, GA 30368-2101
Phone (863) 603-6565

Other identifiers 2

IdentifierTypeStateIssuer
1497748743OtherFLGROUP NPI NUMBER / LRHSI
DA5786OtherFLRAILROAD MEDICARE GROUP ID NUMBER / LRHSI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW6978FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1083825681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102101",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682101",
            "telephone_number": "863-603-6565",
            "fax_number": "863-603-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S FLORIDA AVE",
            "address_2": "# 210",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015276",
            "telephone_number": "863-687-1222",
            "fax_number": "863-603-6546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKOLAWSKI-AGUINAGA",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW6978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER / LRHSI",
            "identifier": "1497748743",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP ID NUMBER / LRHSI",
            "identifier": "DA5786",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.