Individual provider Active NPI

Joleena Mikolazyk, LICSW

  • Mental Health Counselor
  • Falmouth, MA
National Provider Identifier
1598414724
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
350 Gifford St Unit 11
Falmouth, MA 02540-2918
Phone
(617) 283-6485
NPI assigned
Mar 23, 2022
Last updated
Mar 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

350 Gifford St Unit 11
Falmouth, MA 02540-2918

Mailing address

350 Gifford St Unit 11
Falmouth, MA 02540-2918
Phone (617) 283-6485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20220512001331 MA Practitioner - Clinical Social Worker 9830576818 Practice locations: Falmouth, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

120 Main St
Falmouth, MA 02541-1129
Phone (617) 283-6485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
226138MAMDCardiovascular Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1598414724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 GIFFORD ST UNIT 11",
            "city": "FALMOUTH",
            "state": "MA",
            "postal_code": "025402918",
            "telephone_number": "617-283-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 GIFFORD ST UNIT 11",
            "city": "FALMOUTH",
            "state": "MA",
            "postal_code": "025402918",
            "telephone_number": "617-283-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKOLAZYK",
        "first_name": "JOLEENA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falmouth, MA

Sources for this page

Verify at the official NPI Registry.