David G. Mikkola PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

680103141 Issued in MI

Legal business name

DAVID G. MIKKOLA PC

Practice address

30200 Telegraph Rd
Suite 402
Bingham Farms, MI 48025-4502

Phone

(248) 644-3200

Fax

(248) 644-3211

NPI assigned

Jul 17, 2008

Organization subpart

No

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

Authorized official

Name

Mr. David George Mikkola, LMSWNPI 1528258456

Title

President

Phone

(248) 644-3200

Specialties & licenses 1

Addresses

Other names 1

• David g. Mikkola LMSW PC Other name

Medicare fee-for-service enrollment

Enrolled in MI

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.

• David G. Mikkola, LMSW

  • Clinical Social Worker
  • Birmingham, MI
  • NPI 1528258456
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1376707463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30200 TELEGRAPH RD",
            "address_2": "SUITE 402",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254502",
            "telephone_number": "248-644-3200",
            "fax_number": "248-644-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30200 TELEGRAPH RD",
            "address_2": "SUITE 402",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254502",
            "telephone_number": "248-644-3200",
            "fax_number": "248-644-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID G. MIKKOLA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "MIKKOLA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-644-3200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "680103141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "David g. Mikkola LMSW PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shahad Darwish
• Kailey Daugherty
• Jessica Davenport
• Phetsomphou Davenport
• David B Wolf MD PC
• David Gurevitch MD PC
• Laquazaya Davis-Brown
• Makaila Sharon Davis-Croft
• Adayjah Davis
• Alexis Davis

• Clinical Social Worker in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.