Individual provider Active NPI

Mariah McMillan, LCSW

  • Clinical Social Worker
  • Lexington, VA
National Provider Identifier
1386218774
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904012882 Issued in VA
Practice address
25 Northridge LN
Lexington, VA 24450-3399
Phone
(540) 464-8700
NPI assigned
May 19, 2021
Last updated
May 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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 0904012882 VA Primary

Addresses

Primary practice location

25 Northridge LN
Lexington, VA 24450-3399

Mailing address

69 Sugarcamp LN
Stuarts Draft, VA 24477-2916
Phone (540) 560-9520

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20210625002129 VA Practitioner - Clinical Social Worker 0941601090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904012882VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rockbridge Area Free Clinic CurrentSince Apr 28, 2021 Accepting new patients
Rockbridge Area Free Clinic CurrentSince Apr 28, 2021 Accepting new patients

Locations

25 Northridge Ln
Lexington, VA 24450
Phone (540) 464-8700

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1386218774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 SUGARCAMP LN",
            "city": "STUARTS DRAFT",
            "state": "VA",
            "postal_code": "244772916",
            "telephone_number": "540-560-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 NORTHRIDGE LN",
            "city": "LEXINGTON",
            "state": "VA",
            "postal_code": "244503399",
            "telephone_number": "540-464-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "MARIAH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904012882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, VA

Sources for this page

Verify at the official NPI Registry.