Mikhaela Creekmore LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MIKHAELA CREEKMORE LLC

Practice address

4539 Woodgate Dr Ste A8
Janesville, WI 53546-8205

Phone

(608) 201-0591

NPI assigned

Jun 14, 2024

Last updated

Jun 14, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mikhaela Creekmore, LCSWNPI 1689026965

Title

Ceo

Phone

(608) 201-0591

Specialties & licenses 1

Addresses

Other names 1

• Mikhaela Creekmore LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mikhaela K Creekmore, LCSW

  • Clinical Social Worker
  • Janesville, WI
  • NPI 1689026965
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1306689617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4754 SUMPTER DR",
            "city": "MILTON",
            "state": "WI",
            "postal_code": "535638417",
            "telephone_number": "608-201-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4539 WOODGATE DR STE A8",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535468205",
            "telephone_number": "608-201-0591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIKHAELA CREEKMORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "CREEKMORE",
        "authorized_official_first_name": "MIKHAELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "608-201-0591",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mikhaela Creekmore LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Patrick D Meyer, MD
• MHC Hearing 2 LLC (Elite Hearing Centers of America)
• Craig Michelsen, MD
• Daniel Mickelson, SAC-IT
• Elyse Joy Midas
• Lisa Marie Millard, MD
• Benjamin C. Miller, PMHNP
• Dale E Miller, MD
• Edward C Miller, MD
• Jessica Leigh Miller, MD

• Clinical Social Worker in Janesville, WI
• Providers in Janesville, 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 Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.