Kimberly Sue Miller

Primary specialty

Social WorkerTaxonomy code 104100000X

License

PO14249 Issued in NC

Practice address

10801 Monroe Rd
Matthews, NC 28105-8335

Phone

(704) 733-7108

NPI assigned

Jan 3, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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.

• Cedar Creek Counseling PLLC

  • Clinical Social Worker
  • Monroe, NC
  • NPI 1417704529
  NPD Authorized official

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

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1073152336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 PLEASANT GROVE CH RD",
            "city": "MARSHVILLE",
            "state": "NC",
            "postal_code": "281039052",
            "telephone_number": "704-733-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 MONROE RD",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281058335",
            "telephone_number": "704-733-7108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1428 Ellen St Ste B",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NC",
            "postal_code": "281125286",
            "country_code": "US",
            "telephone_number": "704-438-9901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-03",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NC",
            "license": "PO14249",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P014249",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Milked Lactation Services, LLC
• Aaron Matthew Miller
• Hannah McKenzie Miller
• Josie Miller, BCBA
• Justin Britt Miller, MD
• Timothy Patrick Miller, PA-C
• Mind Garden Behavioral Health, PLLC
• Mindful Mountain Therapy and Wellness, PLLC
• Mindful Movements, PLLC
• Mindfully Balanced Therapy PLLC

• Social Worker in Matthews, NC
• Providers in Matthews, NC by specialty
• Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.