Eric Mikelait, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801034036 Issued in MI

Practice address

915 Airport Rd
Jackson, MI 49202-1850

Phone

(517) 740-6239

Fax

(517) 740-6239

NPI assigned

Feb 21, 2006

Last updated

Sep 20, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Targeted Neurofeedback and Psychotherapy Services, PLLC

  • Clinical Social Worker
  • Jackson, MI
  • NPI 1578999603
  NPD (past) Authorized official

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1134194467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3008 S WOODDALE DR",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033767",
            "telephone_number": "517-740-6239",
            "fax_number": "517-740-6239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 AIRPORT RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021850",
            "telephone_number": "517-740-6239",
            "fax_number": "517-740-6239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKELAIT",
        "first_name": "ERIC",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801034036",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "05842",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801034036",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134194467",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "698800800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mid-Michigan Gastroenterology Consultants PC
• Jamie Middlebrook
• Amber Midena
• Diana L. Midgley, L.M.S.W.
• Midwifery Care for All LLC
• Bradley Jordan Mikesell, DO
• Patricia Millenbach, LMSW
• Millennium Optimum Care, LLC
• Alexis Elise Miller
• Annette Miller

• Social Worker in Jackson, MI
• Providers in Jackson, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.