Nicole Adela Mielnicki, LCSWA

Primary specialty

Social WorkerTaxonomy code 104100000X

License

P012382 Issued in NC

Practice address

5200 Park Rd Ste 102C
Charlotte, NC 28209-3650

Phone

(704) 433-5267

NPI assigned

Jun 7, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 3, 2024 through Dec 3, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cauthen Counseling and Consulting, PLLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1144710229
  NPD (past)

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1124511878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 WATERFORD KNOLL DR APT 1527",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282268650",
            "telephone_number": "631-255-3819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 PARK RD STE 102C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093650",
            "telephone_number": "704-433-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIELNICKI",
        "first_name": "NICOLE",
        "middle_name": "ADELA",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "P012382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midway Healthcare
• Midwood Counseling, PLLC.
• Midwood Eye Optometry PLLC (Midwood Eye)
• Jaclyn M Mieczkowski, FNP
• Katherine Marie Mielke, MD
• Amy Diane Mierzwa, DPT
• Jakub Mieszczak, MD
• George S Miffleton, OD
• Ahmed R Migdadi, DC
• Amanda Corrine Migitsch, PHARMD

• Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.