Individual provider Active NPI

Elizabeth L. Miller, LSW

  • Clinical Social Worker
  • Perrysburg, OH
National Provider Identifier
1043702418
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1451265 Issued in OH
Practice address
30000 E River Rd
Perrysburg, OH 43551
Phone
(419) 931-3440
Fax
(419) 661-4020
NPI assigned
Jun 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.1451265 OH Primary

Addresses

Primary practice location

30000 E River Rd
Perrysburg, OH 43551

Mailing address

30000 E River Rd
Perrysburg, OH 43551-3429
Phone (419) 931-3440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20211015000621 FL Practitioner - Clinical Social Worker 8325393259 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mtca Psychological Services P.a. CurrentSince Jun 14, 2021 Accepting new patients

Locations

7091 Atlantic Ave
Delray Beach, FL 33446
Phone (561) 558-2149

6067 Hollywood Blvd
Ste 200
Hollywood, FL 33024

16853 NE 2nd Ave
Ste S304
North Miami Beach, FL 33162

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1043702418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30000 E RIVER RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435513429",
            "telephone_number": "419-931-3440",
            "fax_number": "419-661-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30000 E RIVER RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "43551",
            "telephone_number": "419-931-3440",
            "fax_number": "419-661-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ELIZABETH",
        "middle_name": "L.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-01",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1451265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.