Individual provider Active NPI

Alphonso Lee Miller, LCSW

  • Clinical Social Worker
  • Arlington, TX
National Provider Identifier
1023503844
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1700 Covemeadow Dr
Arlington, TX 76012-5407
Phone
(281) 836-3704
NPI assigned
Jun 25, 2018
Last updated
Nov 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X 67658 TX
Clinical Social Worker 1041C0700X TX Primary

Addresses

Primary practice location

1700 Covemeadow Dr
Arlington, TX 76012-5407

Mailing address

PO Box 1121
Roseburg, OR 97470-0254
Phone (541) 492-0241

Other practice location 1

6649 N Riverside Dr
Fort Worth, TX 76137-6640
Phone (817) 847-1860

Other practice location 2

548 SE Jackson St
Roseburg, OR 97470-4983
Phone (541) 440-3532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20231011000423 TX Practitioner - Clinical Social Worker 6901251966 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Invicta Healthcare PLLCGroup PAC ID 5698016301, 7 clinicians

Practice addresses (Care Compare)

9545 N Beach St
Suite 101
Fort Worth, TX 76244-6470
Phone (817) 381-9650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
67658TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Jul 11, 2024 Accepting new patients
Invicta Healthcare PLLC CurrentSince Jul 1, 2024 Accepting new patients
Beyond the Gray Sky LLC CurrentSince Aug 13, 2023 Accepting new patients
Shine Medical Providers PC Past Accepting new patients

Locations

1412 W Magnolia Ave
Ste 210
Fort Worth, TX 76104
Phone (855) 914-5753

9545 N Beach St
Ste 101
Fort Worth, TX 76244
Phone (817) 381-9650

1000 Post and Paddock St
Ste 102
Grand Prairie, TX 75050

191 W Southlake Blvd
Ste 100
Southlake, TX 76092
Phone (817) 381-9650

Organizations & group practices 4

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": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1023503844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1121",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700254",
            "telephone_number": "541-492-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 COVEMEADOW DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760125407",
            "telephone_number": "281-836-3704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6649 N Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761376640",
            "country_code": "US",
            "telephone_number": "817-847-1860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "548 SE Jackson St",
            "address_purpose": "LOCATION",
            "city": "Roseburg",
            "state": "OR",
            "postal_code": "974704983",
            "country_code": "US",
            "telephone_number": "541-440-3532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ALPHONSO",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-25",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "67658",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.