Individual provider Active NPI

Jason Miller, PH.D., LPCCS

  • Professional Counselor
  • Stow, OH
National Provider Identifier
1104619014
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.0600548-SUPV Issued in OH
Practice address
3425 Kent Rd
Stow, OH 44224-4534
Phone
(330) 835-7477
NPI assigned
May 23, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.0600548-SUPV OH Primary

Addresses

Primary practice location

3425 Kent Rd
Stow, OH 44224-4534

Mailing address

4581 Bunker LN
Stow, OH 44224-5159
Phone (504) 214-2942

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
E.0600548-SUPVOHMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1104619014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4581 BUNKER LN",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442245159",
            "telephone_number": "504-214-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 KENT RD",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442244534",
            "telephone_number": "330-835-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JASON",
        "credential": "PH.D., LPCCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0600548-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stow, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; 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.