Active NPI
Jeanne Kay Miilu, LLMSW
- Social Worker
- Silver City, NM
National Provider Identifier
1821393711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801092771
- Practice address
- 114 W 11TH St
Silver City, NM 88061-5124 - Phone
- (575) 388-1511
- Fax
- (575) 313-8234
- NPI assigned
- Jan 24, 2011
- Last updated
- Jul 21, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | ||
| Social Worker | 104100000X | 6801092771 | MI | Primary |
Addresses
Primary practice location
114 W 11TH St
Silver City, NM 88061-5124
Mailing address
530 De Moss St
Lordsburg, NM 88045-2618
Phone (575) 542-2369
Other practice location 1
703 N 2nd Ave
Iron River, MI 49935-1451
Phone (906) 265-5126
Other practice location 2
530 De Moss St
Lordsburg, NM 88045-2618
Phone (575) 542-2369
Other names 1
- Jeanne Kay Gustafson
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 |
|---|---|---|---|
| 6801092771 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1821393711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 DE MOSS ST",
"city": "LORDSBURG",
"state": "NM",
"postal_code": "880452618",
"telephone_number": "575-542-2369",
"fax_number": "575-542-2388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 W 11TH ST",
"city": "SILVER CITY",
"state": "NM",
"postal_code": "880615124",
"telephone_number": "575-388-1511",
"fax_number": "575-313-8234"
}
],
"practiceLocations": [
{
"address_1": "703 N 2nd Ave",
"address_purpose": "LOCATION",
"city": "Iron River",
"state": "MI",
"postal_code": "499351451",
"country_code": "US",
"telephone_number": "906-265-5126",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "530 De Moss St",
"address_purpose": "LOCATION",
"city": "Lordsburg",
"state": "NM",
"postal_code": "880452618",
"country_code": "US",
"telephone_number": "575-542-2369",
"fax_number": "575-542-2388",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIILU",
"first_name": "JEANNE",
"middle_name": "KAY",
"credential": "LLMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-24",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801092771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JEANNE",
"last_name": "GUSTAFSON",
"middle_name": "KAY",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Silver City, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.