Individual provider Active NPI

Karen Eileen McMillan, LCSW, LCADC

  • Addiction (Substance Use Disorder) Counselor
  • Elkton, MD
National Provider Identifier
1205050127
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCA236 Issued in MD
Practice address
212 Blue Ball Ave
Elkton, MD 21921-5222
Phone
(410) 620-6077
Fax
(410) 620-6081
NPI assigned
Apr 12, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCA236 MD Primary

Addresses

Primary practice location

212 Blue Ball Ave
Elkton, MD 21921-5222

Mailing address

212 Blue Ball Ave
Elkton, MD 21921-5222
Phone (410) 620-6077

Other identifiers 1

IdentifierTypeStateIssuer
101YA0400XMedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070904000172 DE Practitioner - Clinical Social Worker 9436242799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
A Center for Mental Wellness, Inc.Group PAC ID 1456408897, 12 clinicians

Practice addresses (Care Compare)

25 S Old Baltimore Pike
Newark, DE 19702-1540
Phone (302) 266-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCA236MDMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
A Center for Mental Wellness, Inc. Addiction (Substance Use Disorder) CurrentSince Dec 27, 2014 Accepting new patients
Harmonious Mind LLC PastSince Sep 1, 2005 Accepting new patients

Locations

121 W Loockerman St
Dover, DE 19904
Phone (302) 674-1397

25 S Old Baltimore Pike
Newark, DE 19702
Phone (302) 266-6200

25 S Old Baltimore Pike
Ste 201
Newark, DE 19702
Phone (302) 266-6200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1205050127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 BLUE BALL AVE",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215222",
            "telephone_number": "410-620-6077",
            "fax_number": "410-620-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 BLUE BALL AVE",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215222",
            "telephone_number": "410-620-6077",
            "fax_number": "410-620-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "KAREN",
        "middle_name": "EILEEN",
        "name_prefix": "Ms.",
        "credential": "LCSW, LCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "LCA236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YA0400X",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

Verify at the official NPI Registry.