Active NPI
Lauren Ilene Mirkin, MS, CNS, LDN LCPC
- Nutritionist
- Lutherville, MD
National Provider Identifier
1609085877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- DX2974
- Practice address
- 2360 West Joppa Rd. Joppa Concourse, Suite 200
Johns Hopkins Integrative Medicine and Digestive Center
Lutherville, MD 21093 - Phone
- (443) 326-7023
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC5610 | MD | |
| Nutritionist | 133N00000X | DX2974 | MD | Primary |
Addresses
Primary practice location
2360 West Joppa Rd. Joppa Concourse, Suite 200
Johns Hopkins Integrative Medicine and Digestive Center
Lutherville, MD 21093
Mailing address
2520 Willow Glen Drive
Baltimore, MD 21209
Phone (443) 326-7023
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231214000071 | MD | Practitioner - Mental Health Counselor | 7618326745 | Practice locations: Baltimore, MD |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Johns Hopkins University School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2520 Willow Glen Dr
Baltimore, MD 21209-3135
Phone (443) 326-7023
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Specialist, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC5610 | MD | MD | Professional Counselor |
| DX2974 | MD | MD | Nutritionist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johns Hopkins University | Current | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Holistic Counseling Help-LLC | Professional | Past | Accepting new patients |
Locations
2360 W Joppa Rd
Ste 200
Timonium, MD 21093
Phone (410) 828-3585
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Timonium, MD
- NPI 1699635532
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725926400000",
"number": "1609085877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2520 WILLOW GLEN DRIVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21209",
"telephone_number": "443-326-7023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2360 WEST JOPPA RD. JOPPA CONCOURSE, SUITE 200",
"address_2": "JOHNS HOPKINS INTEGRATIVE MEDICINE AND DIGESTIVE CENTER",
"city": "LUTHERVILLE",
"state": "MD",
"postal_code": "21093",
"telephone_number": "443-326-7023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRKIN",
"first_name": "LAUREN",
"middle_name": "ILENE",
"name_prefix": "Mrs.",
"credential": "MS, CNS, LDN LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2024-09-10",
"certification_date": "2024-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC5610",
"primary": false
},
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "MD",
"license": "DX2974",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lutherville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.