Michelle Renne Miller, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

20042044A Issued in IN

Practice address

4630 W Jefferson Blvd
Ste 11a
Fort Wayne, IN 46804-6800

Phone

(260) 434-1606

Fax

(260) 434-1612

NPI assigned

Aug 17, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Life Transitions Counseling Center, LLC

  • Counseling Psychologist
  • Fort Wayne, IN
  • NPI 1912356783
  NPD (past) Authorized official

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467849600000",
    "number": "1003929456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4630 W JEFFERSON BLVD",
            "address_2": "STE 11A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046800",
            "telephone_number": "260-434-1606",
            "fax_number": "260-434-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 W JEFFERSON BLVD",
            "address_2": "STE 11A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046800",
            "telephone_number": "260-434-1606",
            "fax_number": "260-434-1612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MICHELLE",
        "middle_name": "RENNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2016-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IN",
            "license": "20042044A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luke R Miller, M.D.
• Lydia Anne Miller
• Lynn Marie Miller, ATC
• Marissa Miller, NP
• Mark Miller
• Nathan Paul Miller, DPT
• Parker John Miller, OD
• Rachel M Miller, N.P.
• Rachel Mae Miller, MA, BCBA, LLP
• Ronald Lynn Miller

• Counseling Psychologist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Counseling Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; 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.