Individual provider Active NPI

Caitlin Mikulicich, LMFT

  • Mental Health Counselor
  • Encinitas, CA
National Provider Identifier
1891377313
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
133130 Issued in CA
Practice address
317 N El Camino Real Ste 306
Encinitas, CA 92024-2814
Phone
(760) 450-7303
NPI assigned
Apr 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 116051 CA
Mental Health Counselor 101YM0800X 133130 CA Primary

Addresses

Primary practice location

317 N El Camino Real Ste 306
Encinitas, CA 92024-2814

Mailing address

317 N El Camino Real Ste 306
Encinitas, CA 92024-2814
Phone (760) 450-7303

Other practice location 1

6520 Ambrosia Ln Apt 1227
Carlsbad, CA 92011-2616
Phone (858) 922-0323

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
116051CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1891377313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 N EL CAMINO REAL STE 306",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242814",
            "telephone_number": "760-450-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 N EL CAMINO REAL STE 306",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242814",
            "telephone_number": "760-450-7303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6520 Ambrosia Ln Apt 1227",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "920112616",
            "country_code": "US",
            "telephone_number": "858-922-0323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIKULICICH",
        "first_name": "CAITLIN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-23",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "116051",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "133130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

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

Verify at the official NPI Registry.