Active NPI
Monika Mikkelsen
- Clinical Social Worker
- Meridian, ID
National Provider Identifier
1174954804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LMSW-31791
- Practice address
- 205 E Watertower St
Meridian, ID 83642-6282 - Phone
- (208) 914-2230
- NPI assigned
- Dec 5, 2013
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LMSW-31791 | ID | Primary |
Addresses
Primary practice location
205 E Watertower St
Meridian, ID 83642-6282
Mailing address
99 N Canyon St
Nampa, ID 83651
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
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-31791 | ID | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386201600000",
"number": "1174954804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 N CANYON ST",
"city": "NAMPA",
"state": "ID",
"postal_code": "83651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 E WATERTOWER ST",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836426282",
"telephone_number": "208-914-2230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKKELSEN",
"first_name": "MONIKA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-05",
"last_updated": "2013-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LMSW-31791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.