Shannon Marie Miller, LPCC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.2203157-SUPV Issued in OH

Practice address

3645 Ridge Mill Dr
Hilliard, OH 43026-7752

Phone

(614) 457-7876

Fax

(614) 457-7896

NPI assigned

Oct 15, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Hold Space Counseling

  • Community/Behavioral Health Agency
  • Columbus, OH
  • NPI 1548851249
  NPD (past)

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1013483395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 RIDGE MILL DR",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430267752",
            "telephone_number": "614-457-7876",
            "fax_number": "614-457-7896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 RIDGE MILL DR",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430267752",
            "telephone_number": "614-457-7876",
            "fax_number": "614-457-7896"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 E Livingston Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052618",
            "country_code": "US",
            "telephone_number": "614-722-8210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LPCC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2203157-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1473276",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carla Miller, PHD, RD
• Erin Wilford Miller, DPT
• Kelli K Miller, APRN-CNP, WHNP-BC
• Lyndi Ann Miller, PA-C
• Michael David Miller, MD
• Vicki L Miller, M.D.
• Colin Minner, DPT
• Minuteclinic Diagnostic of Ohio LLC
• Minuteclinic Diagnostic of Ohio LLC
• Minuteclinic Primary Care Ohio LLC

• All providers in Hilliard, OH
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; 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.