Individual provider Active NPI

Lindsey Marie Millikin, LCSW

  • Clinical Social Worker
  • Peoria, IL
National Provider Identifier
1356673545
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.013201 Issued in IL
Practice address
411 Dr. Martin Luther King Jr. Drive
Peoria, IL 61605-2400
Phone
(309) 497-0790
Fax
(309) 497-3564
NPI assigned
Feb 12, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.013201 IL Primary

Addresses

Primary practice location

411 Dr. Martin Luther King Jr. Drive
Peoria, IL 61605-2400

Mailing address

411 Dr. Martin Luther King Jr. Drive
Peoria, IL 61605-2400
Phone (309) 497-0790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.013201ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1265932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265932800000",
    "number": "1356673545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 DR. MARTIN LUTHER KING JR. DRIVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616052400",
            "telephone_number": "309-497-0790",
            "fax_number": "309-497-3564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 DR. MARTIN LUTHER KING JR. DRIVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616052400",
            "telephone_number": "309-497-0790",
            "fax_number": "309-497-3564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLIKIN",
        "first_name": "LINDSEY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-12",
        "last_updated": "2010-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.