MEDICARE: SHAMIKA MILLIKEN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C011233	NC

General Provider Information

NPI Number	:	1942783667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAMIKA MILLIKEN LCSW

Provider Business Mailing Address
First Line	:	4009 SPRINGFIELD CREEK DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-1918
Country	:	US
Telephone Number	:	919-698-2178
Fax Number	:

Provider Business Practice Location Address
First Line	:	4009 SPRINGFIELD CREEK DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-1918
Country	:	US
Telephone Number	:	919-698-2178
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2018
Last Update Date	:	09/09/2018

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