Individual provider Active NPI

Megan Rebecca Miller, LCSW

  • Clinical Social Worker
  • North Little Rock, AR
National Provider Identifier
1104070697
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2308-C Issued in AR
Practice address
21 Bridgeway Rd
North Little Rock, AR 72113-9514
Phone
(501) 771-8502
Fax
(501) 771-8511
NPI assigned
Nov 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1981-M AR
Clinical Social Worker 1041C0700X 2308-C AR Primary

Addresses

Primary practice location

21 Bridgeway Rd
North Little Rock, AR 72113-9514

Mailing address

21 Bridgeway Rd
North Little Rock, AR 72113-9514
Phone (501) 771-8502

Other identifiers 1

IdentifierTypeStateIssuer
172039795MedicaidAR

Other names 1

  • Ms. Megan Rebecca Hicks Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1981-MARMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1104070697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 BRIDGEWAY RD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721139514",
            "telephone_number": "501-771-8502",
            "fax_number": "501-771-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 BRIDGEWAY RD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721139514",
            "telephone_number": "501-771-8502",
            "fax_number": "501-771-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MEGAN",
        "middle_name": "REBECCA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-10",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "1981-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "2308-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172039795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "HICKS",
            "middle_name": "REBECCA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; 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.