Mimi'S House Family Advocacy Center NFP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MIMI'S HOUSE FAMILY ADVOCACY CENTER NFP

Practice address

701 Grand Ave
Waukegan, IL 60085-4109

Phone

(847) 242-1126

NPI assigned

Mar 3, 2026

Organization subpart

No

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

Authorized official

Name

Kerrigan McNulty

Title

President

Phone

(847) 242-1126

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole Paige Burnside, LCSW, CWEL

  • Clinical Social Worker
  • Waukegan, IL
  • NPI 1902781982
  NPD (past)

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

{
    "created_epoch": "1772496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772496000000",
    "number": "1952256174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854109",
            "telephone_number": "847-242-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854109",
            "telephone_number": "847-242-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIMI'S HOUSE FAMILY ADVOCACY CENTER NFP",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-03",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "KERRIGAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-242-1126"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Miller
• Lauren Ilana Miller
• Lisa Miller, RN
• Todd S Miller
• Yvette M Miller, P.T.A.
• Kayla E Ming, RN
• Wendy Jahayra Miralda, RN
• Annie Mirza, DDS
• Adam Miscichowski
• Sarah Marie Mitchell

• Clinical Social Worker in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; 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.