Mina Kirkova, MA, MSW, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15911 Issued in MD

Practice address

3009 Jackson Ridge CT
Phoenix, MD 21131

Phone

(410) 988-7247

NPI assigned

Aug 5, 2007

Last updated

Jun 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1114118387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3009 JACKSON RIDGE CT",
            "city": "PHOENIX",
            "state": "MD",
            "postal_code": "211311459",
            "telephone_number": "410-988-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 JACKSON RIDGE CT",
            "city": "PHOENIX",
            "state": "MD",
            "postal_code": "21131",
            "telephone_number": "410-988-7247"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11350 McCormick Rd Ste 408",
            "address_purpose": "LOCATION",
            "city": "Hunt Valley",
            "state": "MD",
            "postal_code": "210311002",
            "country_code": "US",
            "telephone_number": "410-988-7247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRKOVA",
        "first_name": "MINA",
        "credential": "MA, MSW, LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4478",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Phoenix, MD
• Providers in Phoenix, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.