Mica Ollila, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2019036740 Issued in MO

Practice address

3817 S Virginia PL
Springfield, MO 65807-5270

Phone

(417) 527-0618

NPI assigned

Jun 7, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Mica Conner Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cummins Behavioral Health Systems, Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Avon, IN
  • NPI 1740232115
  NPD

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1356790679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3817 S VIRGINIA PL",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075270",
            "telephone_number": "417-527-0618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3817 S VIRGINIA PL",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075270",
            "telephone_number": "417-527-0618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLLILA",
        "first_name": "MICA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008420A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2019036740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14416451",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490075538",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICA",
            "last_name": "CONNER",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jamie Lynn Oleson, MSN, APRN, FNP-BC
• George Chapman Olive II, MD
• Madalyn Jeanne Olive
• Chad Oliver, PA
• Vanessa R Oller
• Matthew Olney, DO
• Emily Rebecca Olroyd, PSY.D.
• Emily Beth Olsen, LCSW
• Teresa A. Olsen, MD
• Grant Olson

• Clinical Social Worker in Springfield, MO
• Providers in Springfield, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.