Individual provider Active NPI

Ann LK Millikin, LCPC

  • Professional Counselor
  • Maryville, IL
National Provider Identifier
1629188792
Registry record updated Feb 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180003680 Issued in IL
Practice address
2016 Vadalabene Dr
Suite a
Maryville, IL 62062-6901
Phone
(618) 604-1696
Fax
(618) 288-0737
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180003680 IL Primary

Addresses

Primary practice location

2016 Vadalabene Dr
Suite a
Maryville, IL 62062-6901

Mailing address

515 Acorn Way
Lebanon, IL 62254
Phone (618) 537-6337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240328003243 IL Practitioner - Mental Health Counselor 5890133680 Practice locations: Maryville, IL

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2016 Vadalabene Dr
Maryville, IL 62062-6901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180003680ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ann LK Millikin, LCPC CurrentSince Oct 30, 2001 Accepting new patients

Locations

2016 Vadalabene Dr
Ste A
Maryville, IL 62062
Phone (618) 604-1696

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1629188792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 ACORN WAY",
            "city": "LEBANON",
            "state": "IL",
            "postal_code": "62254",
            "telephone_number": "618-537-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 VADALABENE DR",
            "address_2": "SUITE A",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620626901",
            "telephone_number": "618-604-1696",
            "fax_number": "618-288-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLIKIN",
        "first_name": "ANN",
        "middle_name": "LK",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180003680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.