Mike P. Homan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.004407 Issued in IL

Practice address

815 E 5TH St
Suite 101
Alton, IL 62002

Phone

(618) 474-6246

Fax

(618) 474-6242

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Michael Phillip Homan Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1952410060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAINT ANTHONY'S WAY",
            "address_2": "815 E 5TH ST. SUIT 101",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "62002",
            "telephone_number": "618-465-2571",
            "fax_number": "618-463-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 E 5TH ST",
            "address_2": "SUITE 101",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "62002",
            "telephone_number": "618-474-6246",
            "fax_number": "618-474-6242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMAN",
        "first_name": "MIKE",
        "middle_name": "P.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.004407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LCSW LICENSE",
            "identifier": "149.004407",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "HOMAN",
            "middle_name": "PHILLIP",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jordyn M Hoemmen, WHNP
• Sarah Ann Hogue
• Katie Holland
• Michele Holloway, MSW.LSW
• Mary Holmes, BSN,RN
• Home Care Pharmacy Refill Ctr
• Autumn Hood, BS
• Sylvia G Hoormann, CRNA
• Christine Hoover
• Patricia Ellen Horn, M.ED.

• Clinical Social Worker in Alton, IL
• Providers in Alton, 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 Sep 17, 2015; 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.