Active NPI
Michelle Miller
- Clinical Psychologist
- Hackensack, NJ
National Provider Identifier
1033590922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5480
- Practice address
- 411 Hackensack Ave
Hackensack, NJ 07601-6328 - Phone
- (201) 465-8111
- NPI assigned
- Jun 16, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5480 | NJ | Primary |
| Clinical Psychologist | 103TC0700X | 020985 | NY |
Addresses
Primary practice location
411 Hackensack Ave
Hackensack, NJ 07601-6328
Mailing address
23 Short Hills Cir Apt 1B
Millburn, NJ 07041-1244
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5480 | NJ | MD | Clinical Psychologist |
| 020985 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434585600000",
"number": "1033590922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 SHORT HILLS CIR APT 1B",
"city": "MILLBURN",
"state": "NJ",
"postal_code": "070411244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 HACKENSACK AVE",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076016328",
"telephone_number": "201-465-8111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-16",
"last_updated": "2015-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "5480",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "020985",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.