Individual provider Active NPI

Miakita Richardson, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Greensboro, NC
National Provider Identifier
1144569294
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
3060 Issued in NC
Practice address
2303 Sidney Porter Dr
Greensboro, NC 27405-1694
Phone
(336) 675-1924
Fax
(336) 675-1924
NPI assigned
Feb 10, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 3060-A NC
Social Worker 104100000X
Addiction (Substance Use Disorder) Counselor 101YA0400X 3060 NC Primary

Addresses

Primary practice location

2303 Sidney Porter Dr
Greensboro, NC 27405-1694

Mailing address

2303 Sidney Porter Dr
Greensboro, NC 27405-1694
Phone (336) 675-1924

Other practice location 1

100 S Marshall St
suite 100
Winston Salem, NC 27101-2843
Phone (336) 723-4130

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3060-ANCMDAddiction (Substance Use Disorder) Counselor
3060NCMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1360454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1144569294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2303 SIDNEY PORTER DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274051694",
            "telephone_number": "336-675-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2303 SIDNEY PORTER DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274051694",
            "telephone_number": "336-675-1924",
            "fax_number": "336-675-1924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 S Marshall St",
            "address_2": "suite 100",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271012843",
            "country_code": "US",
            "telephone_number": "336-723-4130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "MIAKITA",
        "credential": "LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "3060-A",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "3060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.