De'Voncia Lachel Mickins

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P015383 Issued in NC

Practice address

104 E Old US 74/76
Lake Waccamaw, NC 28450-1927

Phone

(252) 521-0773

NPI assigned

Mar 30, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1992383103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 OLD HOMESTEAD RD",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285046854",
            "telephone_number": "252-521-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E OLD US 74/76",
            "city": "LAKE WACCAMAW",
            "state": "NC",
            "postal_code": "284501927",
            "telephone_number": "252-521-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKINS",
        "first_name": "DE'VONCIA",
        "middle_name": "LACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P015383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "devoncia.mickins@bghnc.org",
            "affiliation": "N",
            "endpointDescription": "devoncia.mickens@bghnc.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "855 Old Homestead Rd",
            "city": "Kinston",
            "state": "NC",
            "country_code": "US",
            "postal_code": "285046854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Teresa B Hopkins, FNP
• Journeys Healthcare
• Lake Pointe Assisted Living, Inc.
• Lake Waccamaw Fire & Rescue Squad
• Lake Waccamaw Primary Care, PLLC
• New Opportunities of Columbus Co.
• Danielle Nicole Poteat, LCSWA
• Premier Living and Healthcare Center LLC
• Premier Living and Rehab Center
• Amy Lawson Richardson, LCSW

• All providers in Lake Waccamaw, NC
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.