Active NPI
Carrie Ann Miller
- Clinical Social Worker
- Jackson, MI
National Provider Identifier
1104470640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801105296
- Practice address
- 3300 Lansing Ave
Jackson, MI 49202 - Phone
- (517) 784-2929
- NPI assigned
- Aug 1, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801105296 | MI | Primary |
Addresses
Primary practice location
3300 Lansing Ave
Jackson, MI 49202
Mailing address
5311 Brooklyn Road Apartment 10
Jackson, MI 49201
Phone (304) 377-4528
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801105296 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564617600000",
"number": "1104470640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5311 BROOKLYN ROAD APARTMENT 10",
"city": "JACKSON",
"state": "MI",
"postal_code": "49201",
"telephone_number": "304-377-4528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 LANSING AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "49202",
"telephone_number": "517-784-2929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "CARRIE",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-01",
"last_updated": "2019-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801105296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.