Provider Demographics
NPI:1205626694
Name:M MIDKIFF, MISTY (LCSW)
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:
Last Name:M MIDKIFF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 ONEIDA DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-2303
Mailing Address - Country:US
Mailing Address - Phone:469-865-3739
Mailing Address - Fax:
Practice Address - Street 1:1329 ONEIDA DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-2303
Practice Address - Country:US
Practice Address - Phone:469-865-3739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX656961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical