Individual provider Active NPI

Alyssa Brooke Miller, MSW, LISW

  • Social Worker
  • Lebanon, OH
National Provider Identifier
1013608785
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I.2204112 Issued in OH
Practice address
825 Hart Road
Lebanon, OH 45036-8699
Phone
(513) 934-5899
Fax
(513) 934-2466
NPI assigned
May 15, 2023
Last updated
Jul 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.2204112 OH
Social Worker 104100000X I.2204112 OH Primary

Addresses

Primary practice location

825 Hart Road
Lebanon, OH 45036-8699

Mailing address

560 Beckley Farm Way
Springboro, OH 45066-9483
Phone (937) 479-5707

Other practice location 1

560 Beckley Farm Way
Springboro, OH 45066-9483
Phone (937) 479-5707

Other practice location 2

3333 Burnet Ave
Cincinnati, OH 45229-3026
Phone (513) 803-9600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230728002493 OH Practitioner - Clinical Social Worker 1658732243 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.2204112OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Medical Center Social Worker CurrentSince Jul 13, 2023 Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

825 Hart Rd
Lebanon, OH 45036
Phone (513) 934-5800

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1013608785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 BECKLEY FARM WAY",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450669483",
            "telephone_number": "937-479-5707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 HART ROAD",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450368699",
            "telephone_number": "513-934-5899",
            "fax_number": "513-934-2466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "560 Beckley Farm Way",
            "address_purpose": "LOCATION",
            "city": "Springboro",
            "state": "OH",
            "postal_code": "450669483",
            "country_code": "US",
            "telephone_number": "937-479-5707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 Burnet Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452293026",
            "country_code": "US",
            "telephone_number": "513-803-9600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ALYSSA",
        "middle_name": "BROOKE",
        "credential": "MSW, LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2204112",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.2204112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, OH

Sources for this page

Verify at the official NPI Registry.