Jaquan Jaleel McMillian

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0851641 Issued in NY

Practice address

2384 Atlantic Ave
4TH Floor
Brooklyn, NY 11233-3402

Phone

(718) 272-6025

Fax

(718) 922-7416

NPI assigned

Nov 17, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Institue for Community Living

  • In Home Supportive Care Agency
  • Brooklyn, NY
  • NPI 1871897074
  NPD (past)
• Institute for Community Living

  • Community/Behavioral Health Agency
  • Brooklyn, NY
  • NPI 1164868774
  NPD (past)

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1407220312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2384 ATLANTIC AVE",
            "address_2": "4TH FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112333402",
            "telephone_number": "718-272-6025",
            "fax_number": "718-922-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2384 ATLANTIC AVE",
            "address_2": "4TH FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112333402",
            "telephone_number": "718-272-6025",
            "fax_number": "718-922-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLIAN",
        "first_name": "JAQUAN",
        "middle_name": "JALEEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-17",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "0851641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01305004",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amandla McMillan
• Kinda Camille McMillan
• Nicholin McMillan, FNP
• Rae McMillan, LCSW-R
• Yande McMillan
• Judith McMillian
• Dorothy Marie McMorrow, RN
• Ajani McMullen-Williams
• Leah McMullen
• McMurray Transportation Service Inc.

• Mental Health Counselor in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; 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.