Gary W Mijal, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

674-123 Issued in WI

Practice address

7617 Mineral Point Rd
Ste 300
Madison, WI 53717-1623

Phone

(608) 833-9290

Fax

(608) 833-9691

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295395200000",
    "number": "1285666362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7617 MINERAL POINT RD",
            "address_2": "STE 300",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171623",
            "telephone_number": "608-833-9290",
            "fax_number": "608-833-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7617 MINERAL POINT RD",
            "address_2": "STE 300",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171623",
            "telephone_number": "608-833-9290",
            "fax_number": "608-833-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIJAL",
        "first_name": "GARY",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "674-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN",
            "identifier": "12761",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "391627035010",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39518100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stanley Migala, LPC-IT
• Jill Migon, D.P.M.
• Jeremy Nathaniel Mihajlovich, DO
• Jessica Anne Mihalko
• Amy L Mihm, MS, RD, LAT
• Mike Flint Enterprises Inc
• Mike Flint Enterprises Inc
• Mike Flint Enterprises Inc
• Mike Flint Enterprises Inc
• Mike Flint Enterprises Inc

• Clinical Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; 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.