NPIMap

Individual provider Active NPI

Cary A McMillin, LSW, CDCA

  • Social Worker
  • Ontario, OH
National Provider Identifier
1710492855
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1404 Park Ave W Ste 2
Ontario, OH 44906-2719
Phone
(419) 522-6191
NPI assigned
Dec 12, 2017
Last updated
Oct 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 1700080 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X 164484 OH
Social Worker 104100000X Primary

Addresses

Primary practice location

1404 Park Ave W Ste 2
Ontario, OH 44906-2719

Mailing address

1404 Park Ave W Ste 2
Ontario, OH 44906-2719
Phone (419) 522-6191

Other practice location 1

320 Executive Dr
Marion, OH 43302-6310
Phone (740) 387-5210

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

LicenseStateTypeSpecialty
1700080OHMDCounselor
164484OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Third Street Community Clinic, Inc Past Accepting new patients
Third Street Community Clinic, Inc Past Accepting new patients
Third Street Community Clinic Inc Past Accepting new patients

Organizations & group practices 3

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": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1710492855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 PARK AVE W STE 2",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449062719",
            "telephone_number": "419-522-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 PARK AVE W STE 2",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449062719",
            "telephone_number": "419-522-6191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Executive Dr",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "OH",
            "postal_code": "433026310",
            "country_code": "US",
            "telephone_number": "740-387-5210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMILLIN",
        "first_name": "CARY",
        "middle_name": "A",
        "credential": "LSW, CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "1700080",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "164484",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.