Individual provider Active NPI

Millicent Evette Adadevoh, LCSW

  • Clinical Social Worker
  • Frisco, TX
National Provider Identifier
1659579696
Registry record updated Jun 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
52138 Issued in TX
Practice address
3333 Preston Rd # 3001233
Frisco, TX 75034-9012
Phone
(972) 665-8898
NPI assigned
Jul 10, 2007
Last updated
Jun 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149012263 IL
Clinical Social Worker 1041C0700X 52138 TX Primary

Addresses

Primary practice location

3333 Preston Rd # 3001233
Frisco, TX 75034-9012

Mailing address

PO Box 5805
Frisco, TX 75035-0222
Phone (972) 233-1010

Other practice location 1

235 E 103rd St
Chicago, IL 60628-2807
Phone (773) 371-3668

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
149012263ILMDClinical Social Worker
52138TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Aligned Mosaic Clinical Current Accepting new patients
Assurasource LTD Clinical PastSince Apr 10, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719100800000",
    "number": "1659579696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5805",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750350222",
            "telephone_number": "972-233-1010",
            "fax_number": "972-233-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 PRESTON RD # 3001233",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750349012",
            "telephone_number": "972-665-8898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 E 103rd St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606282807",
            "country_code": "US",
            "telephone_number": "773-371-3668",
            "fax_number": "773-371-3698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADADEVOH",
        "first_name": "MILLICENT",
        "middle_name": "EVETTE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2024-06-23",
        "certification_date": "2024-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012263",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "52138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2024; 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.