Active NPI
Mia Christine Hillert, LCSW-A
- Clinical Social Worker
- Wilmington, NC
National Provider Identifier
1710417019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P011513
- Practice address
- 4130 Oleander Dr Ste 100
Wilmington, NC 28403-6844 - Phone
- (910) 790-5921
- NPI assigned
- Jun 19, 2017
- Last updated
- Jun 19, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P011513 | NC | Primary |
Addresses
Primary practice location
4130 Oleander Dr Ste 100
Wilmington, NC 28403-6844
Mailing address
4301 Saddlebrook Rd
Castle Hayne, NC 28429-5845
Phone (910) 206-1749
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P011513 | Other | NC | NC SOCIAL WORK CERTIFICATION AND LICENSURE BOARD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| P011513 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497830400000",
"number": "1710417019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 SADDLEBROOK RD",
"city": "CASTLE HAYNE",
"state": "NC",
"postal_code": "284295845",
"telephone_number": "910-206-1749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4130 OLEANDER DR STE 100",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284036844",
"telephone_number": "910-790-5921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILLERT",
"first_name": "MIA",
"middle_name": "CHRISTINE",
"credential": "LCSW-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-19",
"last_updated": "2017-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P011513",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC SOCIAL WORK CERTIFICATION AND LICENSURE BOARD",
"identifier": "P011513",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.