Individual provider Active NPI

Kathryn Miller, LCMHC

  • Mental Health Counselor
  • Wilmington, NC
National Provider Identifier
1073354296
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
00149 Issued in NC
Practice address
226 N Front St # 118
Wilmington, NC 28401-3920
Phone
(910) 581-9837
NPI assigned
Jun 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 00149 NC Primary

Addresses

Primary practice location

226 N Front St # 118
Wilmington, NC 28401-3920

Mailing address

226 N Front St # 118
Wilmington, NC 28401-3920

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

LicenseStateTypeSpecialty
00149NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Revive Wellness Center Mental Health CurrentSince Jun 9, 2024 Accepting new patients

Locations

226 N Front St
Ste 118
Wilmington, NC 28401

226 N Front St
#118
Wilmington, NC 28401
Phone (910) 518-9837

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": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1073354296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 N FRONT ST # 118",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284013920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 N FRONT ST # 118",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284013920",
            "telephone_number": "910-581-9837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KATHRYN",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "00149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.