Thaddeus Anthony Miksinski III, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11805 Issued in MD

Practice address

650 Ritchie Hwy
Suite 207
Severna Park, MD 21146-3916

Phone

(410) 315-9350

Fax

(410) 315-9353

NPI assigned

Jul 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Optum Behavioral Care of North Carolina, PC

  • Counseling Psychologist
  • Columbia, MD
  • NPI 1518732833
  Medicare reassignment

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376558098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 FOREST EDGE CT",
            "address_2": "#103 L",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211132833",
            "telephone_number": "410-695-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 RITCHIE HWY",
            "address_2": "SUITE 207",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463916",
            "telephone_number": "410-315-9350",
            "fax_number": "410-315-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKSINSKI",
        "first_name": "THADDEUS",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "11805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Mete, LMSW
• Sheshu Mettu, RPH
• Olivia Jo Meyer
• Mid-Atlantic ENT, LLC
• Nichole Lynn-Hines Miele, PTA
• Abbey Mikutaicis
• Katie Sandbower Milleker, DIPLO.AC.
• Lauri Palmer Miller, LCSW-C
• William W. Kendall Miller III, D.D.S., M.S., P.A.
• Heather C Min, O.D.

• Clinical Social Worker in Severna Park, MD
• Providers in Severna Park, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.