Individual provider Active NPI

Michelle Mikonsky, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Mayfield Village, OH
National Provider Identifier
1184027039
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP-4808 Issued in OH
Practice address
6625 Wilson Mills Rd
Mayfield Village, OH 44143-3406
Phone
(440) 995-7417
NPI assigned
Oct 7, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP-4808 OH Primary

Addresses

Primary practice location

6625 Wilson Mills Rd
Mayfield Village, OH 44143-3406

Mailing address

6625 Wilson Mills Rd
Mayfield Village, OH 44143-3406
Phone (440) 995-7417

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SP-4808OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1184027039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 WILSON MILLS RD",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441433406",
            "telephone_number": "440-995-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 WILSON MILLS RD",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441433406",
            "telephone_number": "440-995-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKONSKY",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-07",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP-4808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield Village, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; 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.