Carly Mikkila, LPC-IT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

S73W16485 Janesville Rd # 202
Muskego, WI 53150-8960

Phone

(920) 395-9857

NPI assigned

Sep 7, 2023

Last updated

Sep 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1629854286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6808 UNIVERSITY AVE STE 108",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535622779",
            "telephone_number": "847-331-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S73W16485 JANESVILLE RD # 202",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531508960",
            "telephone_number": "920-395-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKKILA",
        "first_name": "CARLY",
        "credential": "LPC-IT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Muskego-Norway School District

• Mental Health Counselor in Muskego, WI
• Providers in Muskego, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.