Individual provider Active NPI

Michelle Louise Miner, LCSW-BACS

  • Clinical Social Worker
  • Denham Springs, LA
National Provider Identifier
1073782819
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3141 BACS Issued in LA
Practice address
30826 Linder Rd
Denham Springs, LA 70726-8507
Phone
(225) 665-7878
Fax
(225) 665-7856
NPI assigned
Feb 26, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3141 BACS LA Primary

Addresses

Primary practice location

30826 Linder Rd
Denham Springs, LA 70726-8507

Mailing address

30826 Linder Rd
Denham Springs, LA 70726-8507
Phone (225) 665-7878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20220602002441 OK Practitioner - Clinical Social Worker 8628115045 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3141LAMDMental Health Counselor
3141 BACSLAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
State of Oklahoma CurrentSince May 10, 2022 Accepting new patients
State of Oklahoma CurrentSince May 10, 2022 Accepting new patients
State of Oklahoma Current Accepting new patients
Spectrum Rehab Services, Inc. PastSince Sep 6, 2009 Accepting new patients

Locations

1101 E Monroe Ave
McAlester, OK 74501
Phone (918) 426-7878

2323 S Harvard Ave
Tulsa, OK 74114
Phone (918) 293-2140

Organizations & group practices 4

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": "1203984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1073782819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30826 LINDER RD",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707268507",
            "telephone_number": "225-665-7878",
            "fax_number": "225-665-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30826 LINDER RD",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707268507",
            "telephone_number": "225-665-7878",
            "fax_number": "225-665-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINER",
        "first_name": "MICHELLE",
        "middle_name": "LOUISE",
        "name_prefix": "Miss",
        "credential": "LCSW-BACS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-26",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "3141 BACS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denham Springs, LA

Sources for this page

Verify at the official NPI Registry.