Active NPI
Julie Ann Mimms, LGPC
- Professional Counselor
- Columbia, MD
National Provider Identifier
1154154458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LGP15459
- Practice address
- 9891 Broken Land Pkwy Ste 210
Columbia, MD 21046-3001 - Phone
- (667) 668-2556
- NPI assigned
- Aug 22, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LGP15459 | MD | Primary |
Addresses
Primary practice location
9891 Broken Land Pkwy Ste 210
Columbia, MD 21046-3001
Mailing address
9891 Broken Land Pkwy Ste 210
Columbia, MD 21046-3001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LGP15459 | MD | MD | Professional Counselor |
Interoperability endpoints
- bloomhealthcenters.juliemimms@131200.advancedmd-direct.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724284800000",
"number": "1154154458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9891 BROKEN LAND PKWY STE 210",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210463001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9891 BROKEN LAND PKWY STE 210",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210463001",
"telephone_number": "667-668-2556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIMMS",
"first_name": "JULIE",
"middle_name": "ANN",
"credential": "LGPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-22",
"last_updated": "2024-08-22",
"certification_date": "2024-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LGP15459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.