Active NPI
Mika Elani Pearson, LAPC
- Professional Counselor
- Baxley, GA
National Provider Identifier
1992360358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- APC006943
- Practice address
- 9420 Blackshear Hwy
Baxley, GA 31513-5715 - Phone
- (912) 367-1242
- NPI assigned
- May 1, 2019
- Last updated
- May 1, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | APC006943 | GA | Primary |
Addresses
Primary practice location
9420 Blackshear Hwy
Baxley, GA 31513-5715
Mailing address
131 Burketts Ferry Rd Apt E2
Hazlehurst, GA 31539-7137
Phone (912) 253-6111
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
| License | State | Type | Specialty |
|---|---|---|---|
| APC006943 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia Baptist Children's Homes and Family Ministries, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Baxley, GA
- NPI 1245439116
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556668800000",
"number": "1992360358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 BURKETTS FERRY RD APT E2",
"city": "HAZLEHURST",
"state": "GA",
"postal_code": "315397137",
"telephone_number": "912-253-6111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9420 BLACKSHEAR HWY",
"city": "BAXLEY",
"state": "GA",
"postal_code": "315135715",
"telephone_number": "912-367-1242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "MIKA",
"middle_name": "ELANI",
"credential": "LAPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-01",
"last_updated": "2019-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "APC006943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baxley, GA
- Optim Orthopedics LLC (Optim Orthopedics Baxley)
- Optim Orthopedics, LLC (Optim Orthopedics)
- Optim Orthopedics, LLC (Optim Orthopedics)
- Orthostance Medical LLC
- Spencer M. Paterson, M.D.
- Amanda Kay Petty, FNP-BC
- Platinum PT LLC
- Precision Family Healthcare, LLC
- Precision Labs II LLC
- Ronald S Reagin Sr., DPM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.