Mika Tamara Gill, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

4064-M Issued in AR

Practice address

2126 N 1St St Ste F
Jacksonville, AR 72076-2868

Phone

(501) 982-5000

Fax

(501) 982-5007

NPI assigned

Aug 17, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Families, Inc of Arkansas

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jonesboro, AR
  • NPI 1770535569
  Medicare reassignment NPD
• Families, Inc. of Arkansas

  dba Families, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pocahontas, AR
  • NPI 1275623035
  NPD
• Refresh in-Home Counseling LLC

  dba In Home Counseling

  • Clinical Social Worker
  • Antioch, IL
  • NPI 1609365519
  NPD (past)

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1144500570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-933-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2126 N 1ST ST STE F",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720762868",
            "telephone_number": "501-982-5000",
            "fax_number": "501-982-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "MIKA",
        "middle_name": "TAMARA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-17",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "4064-M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186726795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anakaren Garza, MA, LPC, NCC
• Shana Lynn Genenbacher, MHPP
• Mara George
• Tiarra Gibbons
• Logan Gilbertson, OTR4172
• April Glasgow, QBHP
• John Glenn
• Isabella Noelle Gordon
• GPN Jacksonville LLC
• George Thompson Gray III, D.O.

• Social Worker in Jacksonville, AR
• Providers in Jacksonville, AR by specialty
• Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.