Active NPI
Michael James Casillas, LCSW
- Clinical Social Worker
- North Little Rock, AR
National Provider Identifier
1720312283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3491-C
- Practice address
- 4260 Stockton Dr
Suite a
North Little Rock, AR 72117-2915 - Phone
- (501) 916-9129
- Fax
- (501) 916-9770
- NPI assigned
- Sep 30, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 29549 | CA | |
| Clinical Social Worker | 1041C0700X | 3491-C | AR | Primary |
Addresses
Primary practice location
4260 Stockton Dr
Suite a
North Little Rock, AR 72117-2915
Mailing address
4260 Stockton Dr
Suite a
North Little Rock, AR 72117-2915
Phone (501) 916-9129
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 174400000X | Other | CA | 17-OTHER SERVICES |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3491-C | AR | MD | Clinical Social Worker |
| 29549 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417478400000",
"number": "1720312283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4260 STOCKTON DR",
"address_2": "SUITE A",
"city": "NORTH LITTLE ROCK",
"state": "AR",
"postal_code": "721172915",
"telephone_number": "501-916-9129",
"fax_number": "501-916-9129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4260 STOCKTON DR",
"address_2": "SUITE A",
"city": "NORTH LITTLE ROCK",
"state": "AR",
"postal_code": "721172915",
"telephone_number": "501-916-9129",
"fax_number": "501-916-9770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASILLAS",
"first_name": "MICHAEL",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-30",
"last_updated": "2014-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "29549",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AR",
"license": "3491-C",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "17-OTHER SERVICES",
"identifier": "174400000X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.