Organization Active NPI

Nancy Milbourn, LCSW, PA

  • Clinical Social Worker
  • Little Rock, AR
National Provider Identifier
1316206543
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C494 Issued in AR
Legal business name
NANCY MILBOURN, LCSW, PA
Practice address
5019 Woodlawn Dr
Little Rock, AR 72205-3627
Phone
(501) 681-0567
Fax
(844) 274-3173
NPI assigned
May 8, 2012
Last updated
Feb 15, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Authorized official

Name
Nancy Anne Milbourn, LCSWNPI 1356307953
Title
President
Phone
(501) 681-0567

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C494 AR Primary

Addresses

Primary practice location

5019 Woodlawn Dr
Little Rock, AR 72205-3627

Mailing address

5019 Woodlawn Dr
Little Rock, AR 72205-3627
Phone (501) 681-0567

Other identifiers 1

IdentifierTypeStateIssuer
5S136OtherARPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250903004242 AL Part B Supplier - Clinic/Group Practice 3274796586 Practice locations: Gurley, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455494400000",
    "number": "1316206543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5019 WOODLAWN DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053627",
            "telephone_number": "501-681-0567",
            "fax_number": "844-274-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5019 WOODLAWN DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053627",
            "telephone_number": "501-681-0567",
            "fax_number": "844-274-3173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANCY MILBOURN, LCSW, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-08",
        "last_updated": "2016-02-15",
        "status": "A",
        "authorized_official_last_name": "MILBOURN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-681-0567",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "C494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "5S136",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; 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.