Individual provider Active NPI

Mikeya Vega, LCSW

  • Clinical Social Worker
  • Valdosta, GA
National Provider Identifier
1871902874
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
3312 N Oak Street Ext BLDG D
Valdosta, GA 31605-1066
Phone
(229) 244-2030
Fax
(229) 244-2038
NPI assigned
Aug 5, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

3312 N Oak Street Ext BLDG D
Valdosta, GA 31605-1066

Mailing address

6100 Savannah Rd
Naylor, GA 31641-2581
Phone (229) 834-7356

Other practice location 1

6100 Savannah Rd
Naylor, GA 31641-2581
Phone (229) 834-7356

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131003675 GA Practitioner - Clinical Social Worker 8325491897 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ar Psychiatric and Counseling Center LLCGroup PAC ID 9335326941, 11 clinicians

Practice addresses (Care Compare)

3312 N Oak St Ext
BLDG D
Valdosta, GA 31605-1066
Phone (229) 244-2030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Therapy Center, LLC CurrentSince Sep 1, 2024 Accepting new patients
Ar Psychiatric & Counseling Center LLC CurrentSince Dec 1, 2023 Accepting new patients

Locations

1801 Canterbury Dr
Ste C
Valdosta, GA 31602
Phone (229) 244-2030

3312 N Oak Street Ext
Bldg D
Valdosta, GA 31605
Phone (229) 244-2030

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1871902874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 SAVANNAH RD",
            "city": "NAYLOR",
            "state": "GA",
            "postal_code": "316412581",
            "telephone_number": "229-834-7356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 N OAK STREET EXT BLDG D",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316051066",
            "telephone_number": "229-244-2030",
            "fax_number": "229-244-2038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6100 Savannah Rd",
            "address_purpose": "LOCATION",
            "city": "Naylor",
            "state": "GA",
            "postal_code": "316412581",
            "country_code": "US",
            "telephone_number": "229-834-7356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VEGA",
        "first_name": "MIKEYA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.