Active NPI
Bryan G Miller, PHD, LPC
- Professional Counselor
- Lincoln, NE
National Provider Identifier
1073690855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 552
- Practice address
- 4501 S 70TH
Suite 120
Lincoln, NE 68516-4276 - Phone
- (402) 483-1936
- Fax
- (402) 483-7314
- NPI assigned
- Nov 1, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 552 | NE | Primary |
Addresses
Primary practice location
4501 S 70TH
Suite 120
Lincoln, NE 68516-4276
Mailing address
4501 S 70TH
Suite 120
Lincoln, NE 68516-4276
Phone (402) 483-1936
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47080115226 | Medicaid | NE |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 552 | NE | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Pediatric & Family Therapy Program, LLC | Professional | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Behavioral Pediatric & Family Therapy Program
- Psychologist
- Lincoln, NE
- NPI 1336224971
Professional
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073690855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4501 S 70TH",
"address_2": "SUITE 120",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685164276",
"telephone_number": "402-483-1936",
"fax_number": "402-483-7314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4501 S 70TH",
"address_2": "SUITE 120",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685164276",
"telephone_number": "402-483-1936",
"fax_number": "402-483-7314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "BRYAN",
"middle_name": "G",
"credential": "PHD, LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NE",
"license": "552",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47080115226",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.