Individual provider Active NPI

Alyssa Miller, LGSW

  • School Social Worker
  • Columbia, MD
National Provider Identifier
1104233972
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
20131 Issued in MD
Practice address
5500 Knoll North Dr Ste 370
Columbia, MD 21045-2393
Phone
(410) 837-2050
Fax
(866) 629-0091
NPI assigned
Jul 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 20131 MD Primary

Addresses

Primary practice location

5500 Knoll North Dr Ste 370
Columbia, MD 21045-2393

Mailing address

1111 N Charles St
Baltimore, MD 21201-5505
Phone (410) 837-2050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20200702002219 MD Practitioner - Clinical Social Worker 6608299987 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20131MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chase Brexton Health Services, Inc. CurrentSince Jul 6, 2020 Accepting new patients
Chase Brexton Health Services, Inc. CurrentSince Jul 6, 2020 Accepting new patients

Locations

1111 N Charles St
Baltimore, MD 21201
Phone (410) 486-5991

5500 Knoll North Dr
Ste 370
Columbia, MD 21045
Phone (410) 884-7831

Organizations & group practices 2

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": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1104233972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015505",
            "telephone_number": "410-837-2050",
            "fax_number": "866-629-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 KNOLL NORTH DR STE 370",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452393",
            "telephone_number": "410-837-2050",
            "fax_number": "866-629-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ALYSSA",
        "credential": "LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MD",
            "license": "20131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.