Suzanne Ellis Mikkelson, M.A.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

904 Issued in NC

Practice address

114 Highland Ave
Fayetteville, NC 28305-5306

Phone

(910) 484-0176

Fax

(910) 484-5781

NPI assigned

Jan 29, 2008

Sex

Female

Sole proprietor

No

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Hill City Counseling and Consulting, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lynchburg, VA
  • NPI 1063069185
  Medicare reassignment NPD Authorized official
• Garman & Proffitt Physical Therapy, Inc

  • Physical Therapist
  • Lynchburg, VA
  • NPI 1295826683
  NPD

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1578740924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 HIGHLAND AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055306",
            "telephone_number": "910-484-0176",
            "fax_number": "910-484-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 HIGHLAND AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055306",
            "telephone_number": "910-484-0176",
            "fax_number": "910-484-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKKELSON",
        "first_name": "SUZANNE",
        "middle_name": "ELLIS",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alda Carroleeta Midgette
• Ronald Warren Mikaloff, DDS
• Mike W Choe DDS PA
• Michael Mikhail, MD
• Yana Mikhaylov
• Deborah A Milburn, RD
• Miles 2 Wisdom LLC
• Shamonique Miles
• Milestones Over Fayetteville LLC
• Marissa Millard

• Marriage & Family Therapist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Marriage & Family Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.