Individual provider Active NPI

Heidi M Mikel, MSW

  • Mental Health Counselor
  • San Luis Obispo, CA
National Provider Identifier
1629109426
Registry record updated Dec 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1280 Manzanita Way
San Luis Obispo, CA 93401-7800
Phone
(310) 428-8892
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Mental Health Counselor 101YM0800X 25962 CA

Addresses

Primary practice location

1280 Manzanita Way
San Luis Obispo, CA 93401-7800

Mailing address

1280 Manzanita Way
San Luis Obispo, CA 93401-7800
Phone (310) 428-8892

Other practice location 1

12714 Avalon Blvd
Los Angeles, CA 90061-2730
Phone (323) 777-0130 ext. 230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25962CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670716800000",
    "number": "1629109426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 MANZANITA WAY",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017800",
            "telephone_number": "310-428-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 MANZANITA WAY",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017800",
            "telephone_number": "310-428-8892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12714 Avalon Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900612730",
            "country_code": "US",
            "telephone_number": "323-777-0130 x230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIKEL",
        "first_name": "HEIDI",
        "middle_name": "M",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2022-12-11",
        "certification_date": "2022-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "25962",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2022; 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.