Active NPI
Suzanne L Miller, LCSW
- Clinical Social Worker
- Passaic, NJ
National Provider Identifier
1033120878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 44SC00601200
- Practice address
- 110 Main Ave
Passaic, NJ 07055-4427 - Phone
- (973) 777-7638
- Fax
- (973) 777-9311
- NPI assigned
- Aug 10, 2006
- Last updated
- Nov 24, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC00601200 | NJ | Primary |
Addresses
Primary practice location
110 Main Ave
Passaic, NJ 07055-4427
Mailing address
110 Main Ave
Passaic, NJ 07055-4427
Phone (973) 777-7638
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0263184 | Medicaid | NJ | |
| 145813 000 | Other | NJ | MAGELLAN ID |
| 017236 | Other | NJ | MHN ID |
| 7908369 | Other | NJ | AETNA ID |
| P-435707 | Other | NJ | OXFORD ID |
| 0021784 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606176000000",
"number": "1033120878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 MAIN AVE",
"city": "PASSAIC",
"state": "NJ",
"postal_code": "070554427",
"telephone_number": "973-777-7638",
"fax_number": "973-777-9311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 MAIN AVE",
"city": "PASSAIC",
"state": "NJ",
"postal_code": "070554427",
"telephone_number": "973-777-7638",
"fax_number": "973-777-9311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "SUZANNE",
"middle_name": "L",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-10",
"last_updated": "2020-11-24",
"certification_date": "2020-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SC00601200",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0263184",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN ID",
"identifier": "145813 000",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN ID",
"identifier": "017236",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA ID",
"identifier": "7908369",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD ID",
"identifier": "P-435707",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0021784",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Passaic, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.