Phyllis Wardrett Miller, MSW,LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

CSW000649 Issued in GA

Practice address

204 Church St
Decatur, GA 30030-3328

Phone

(404) 626-9690

Fax

(404) 377-5644

NPI assigned

Sep 7, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dekalb Rape Crisis Center Inc

  • Social Worker
  • Decatur, GA
  • NPI 1750602173
  NPD (past) Authorized official

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1053692848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 CHURCH ST",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303328",
            "telephone_number": "404-626-9690",
            "fax_number": "404-377-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 CHURCH ST",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303328",
            "telephone_number": "404-626-9690",
            "fax_number": "404-377-5644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "PHYLLIS",
        "middle_name": "WARDRETT",
        "name_prefix": "Ms.",
        "credential": "MSW,LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-07",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "CSW000649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CENPATICO",
            "identifier": "132600",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003112377A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "753207",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA INSURANCE",
            "identifier": "3561762",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD OF GEORGIA",
            "identifier": "1902141617",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Blanks Miller III, M.S.
• Kimberly Miller, FNP
• Lois Elayne Miller, RN
• Mark E. Miller
• Nancy Miller
• Sylvia Miller
• Tammy Vanessa Miller, LCSW
• Taniqua A Miller, MD
• Toni Whaley Miller, DMD
• Wanshez T Miller, MA, LPC

• Social Worker in Decatur, GA
• Providers in Decatur, GA by specialty
• Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.

Verify at the official NPI Registry.