Mia Online Therapy Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MIA ONLINE THERAPY SERVICES, LLC

Practice address

1259 Terrace Ave
Adrian, MI 49221-1837

Phone

(313) 409-3120

NPI assigned

Jul 26, 2021

Organization subpart

No

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

Authorized official

Name

Mirjana JovicicNPI 1912570110

Title

Social Worker- Clinical/ Therapist

Phone

(313) 409-3120

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mirjana Jovicic

  • Clinical Social Worker
  • Adrian, MI
  • NPI 1912570110

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730592000000",
    "number": "1679246714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 TERRACE AVE",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211837",
            "telephone_number": "313-409-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 TERRACE AVE",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211837",
            "telephone_number": "313-409-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIA ONLINE THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-26",
        "last_updated": "2024-11-03",
        "certification_date": "2024-11-03",
        "status": "A",
        "authorized_official_last_name": "JOVICIC",
        "authorized_official_first_name": "MIRJANA",
        "authorized_official_title_or_position": "SOCIAL WORKER- CLINICAL/ THERAPIST",
        "authorized_official_telephone_number": "313-409-3120"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Howard Merritt, MD
• Kathy Lee Messervy, RN
• Krystina Meyer
• Nakeyia Marie Meyers, LMSW
• Stephanie Meyers
• Muhammad Rafiq Mian, M.D.
• Michael P Towler DDS PC
• Michael T McAuliffe MD
• Michele a. Gardner, M.D., P.L.L.C.
• Michelle L Lehman, DDS, PLLC

• Clinical Social Worker in Adrian, MI
• Providers in Adrian, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.