Individual provider Active NPI

Carolynn Jeanne Mikulka, LPC-MHSP

  • Professional Counselor
  • Brentwood, TN
National Provider Identifier
1851964464
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5602 Issued in TN
Practice address
9025 Overlook Blvd Ste 200
Brentwood, TN 37027-2710
Phone
(615) 212-5335
NPI assigned
Jul 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5602 TN Primary

Addresses

Primary practice location

9025 Overlook Blvd Ste 200
Brentwood, TN 37027-2710

Mailing address

9025 Overlook Blvd Ste 200
Brentwood, TN 37027-2710
Phone (407) 718-8964

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
5602TNMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1851964464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9025 OVERLOOK BLVD STE 200",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272710",
            "telephone_number": "407-718-8964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9025 OVERLOOK BLVD STE 200",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272710",
            "telephone_number": "615-212-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKULKA",
        "first_name": "CAROLYNN",
        "middle_name": "JEANNE",
        "credential": "LPC-MHSP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "5602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.