Tarik Malachi McMillan, M.S.ED.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

40 Eg Lagrange
Frederiksted, VI 00840

Phone

(340) 332-2717

NPI assigned

Dec 8, 2017

Last updated

Oct 15, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Greater Changes LLC.

  • Mental Health Counselor
  • Frederiksted, VI
  • NPI 1497210256
  Authorized official Same address or phone
• Greater Changes LLC.

  • Community/Behavioral Health Agency
  • Oviedo, FL
  • NPI 1225660608
  NPD

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1750896072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1833",
            "city": "FREDERIKSTED",
            "state": "VI",
            "postal_code": "008411833",
            "telephone_number": "340-332-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 EG LAGRANGE",
            "city": "FREDERIKSTED",
            "state": "VI",
            "postal_code": "00840",
            "telephone_number": "340-332-2717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44 Union Mt Washington",
            "address_purpose": "LOCATION",
            "city": "Christiansted",
            "state": "VI",
            "postal_code": "008200082",
            "country_code": "US",
            "telephone_number": "340-332-2717",
            "fax_number": "340-332-2717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "TARIK",
        "middle_name": "MALACHI",
        "credential": "M.S.ED.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-08",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VI",
            "license": "2-43354-1L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LICENSING AND CONSUMER AFFAIRS",
            "identifier": "2-43354",
            "state": "VI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dannielle Kyrillos
• Ruby J Lake
• Jessica Marie Lignelli, RDH
• Jozette C. Matthews, FNP-BC
• Stephanie T McIntosh Luis
• Medical Health &DME Supplies
• Neighborhood Pharmacy LLC (Neighborhood Pharmacy)
• Latonya R. R. Nesbitt, NP
• Octaviorx Enterprises LLC (Christian's Pharmacy & Medical Supplies)
• Mia Ozimba-Mbuya, DDS

• Mental Health Counselor in Frederiksted, VI
• Providers in Frederiksted, VI by specialty
• Mental Health Counselor in U.S. Virgin Islands

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.