Patti Jane Miller, M.A., L.P.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP3515 Issued in MN

Practice address

4368 Spruce Rd
St Bonifacius, MN 55375-1312

Phone

(612) 812-7857

NPI assigned

May 2, 2007

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

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Mental Health Counselor

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Midwest Center for Emdr Training

  • Psychologist
  • Eden Prairie, MN
  • NPI 1316716731
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073734430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4368 SPRUCE RD",
            "city": "ST BONIFACIUS",
            "state": "MN",
            "postal_code": "553751312",
            "telephone_number": "952-446-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4368 SPRUCE RD",
            "city": "ST BONIFACIUS",
            "state": "MN",
            "postal_code": "553751312",
            "telephone_number": "612-812-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "PATTI",
        "middle_name": "JANE",
        "credential": "M.A., L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Ehalt
• Ashley L Engstrom
• Lacey Machemehl, M.A.
• Chase Matthew Martin, D.C.
• Daniel Ray Miller, MA, LMFT
• Tricia Anne Miller, OTR/L
• Karen Moberg, M.ED, ATC
• Sonja Squiers, MS, LAT, ATC
• St Bonifacius Chiropractic L.L.C. (St. Bonifacius Chiropractic)
• Nathan Michael Tellers, ATC

• Psychologist in St Bonifacius, MN
• Providers in St Bonifacius, MN by specialty
• Psychologist in Minnesota

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.