Individual provider Active NPI

Mykeerah Shanee Miller Zarazua, APSW

  • Social Worker
  • Wisconsin Rapids, WI
National Provider Identifier
1891544342
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
132682-121 Issued in WI
Practice address
1191 Huntington Ave
Wisconsin Rapids, WI 54494-6364
Phone
(715) 818-6443
NPI assigned
May 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 132682-121 WI Primary

Addresses

Primary practice location

1191 Huntington Ave
Wisconsin Rapids, WI 54494-6364

Mailing address

740 6TH Ave
Stevens Point, WI 54481-1514
Phone (715) 347-6622

Other names 1

  • Mykeerah Shanee Miller Former name

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
132682-121WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Opportunity Development Centers, Inc. CurrentSince May 19, 2024 Accepting new patients

Locations

1191 Huntington Ave
Wisconsin Rapids, WI 54494
Phone (715) 424-2712

Organizations & group practices 1

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": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1891544342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 6TH AVE",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544811514",
            "telephone_number": "715-347-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1191 HUNTINGTON AVE",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544946364",
            "telephone_number": "715-818-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZARAZUA",
        "first_name": "MYKEERAH",
        "middle_name": "SHANEE MILLER",
        "credential": "APSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "132682-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYKEERAH",
            "last_name": "MILLER",
            "middle_name": "SHANEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wisconsin Rapids, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.