Individual provider Active NPI

Jennifer Costa McMillan

  • Mental Health Counselor
  • Towson, MD
National Provider Identifier
1174872642
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1122 Kenilworth Dr Ste 416
Towson, MD 21204-2148
Phone
(443) 451-5122
NPI assigned
Aug 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1122 Kenilworth Dr Ste 416
Towson, MD 21204-2148

Mailing address

1122 Kenilworth Dr Ste 416
Towson, MD 21204-2148
Phone (443) 451-5122

Other practice location 1

9 Whipple St Unit 10
Cumberland, RI 02864-5384
Phone (401) 426-2406

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

Practice roles

OrganizationSpecialtyStatusNew patients
Heather Z. Lyons, Licensed Psychologist, LLC Mental Health CurrentSince Sep 8, 2025 Accepting new patients
Heather Z. Lyons, Licensed Psychologist, LLC PastSince Sep 8, 2025 Accepting new patients

Locations

1122 Kenilworth Dr
Ste 416
Towson, MD 21204
Phone (443) 451-5122

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1174872642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 KENILWORTH DR STE 416",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042148",
            "telephone_number": "443-451-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 KENILWORTH DR STE 416",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042148",
            "telephone_number": "443-451-5122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 Whipple St Unit 10",
            "address_purpose": "LOCATION",
            "city": "Cumberland",
            "state": "RI",
            "postal_code": "028645384",
            "country_code": "US",
            "telephone_number": "401-426-2406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "JENNIFER",
        "middle_name": "COSTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-30",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; 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.