Active NPI
Audni Genevieve Miller, PH. D. LISW
- Mental Health Counselor
- Gallup, NM
National Provider Identifier
1104979319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- M-06437
- Practice address
- 607 S Puerco Dr
Gallup, NM 87301-6137 - Phone
- (505) 863-3828
- NPI assigned
- Jan 19, 2007
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | M-06437 | NM | Primary |
Addresses
Primary practice location
607 S Puerco Dr
Gallup, NM 87301-6137
Mailing address
607 S Puerco Dr
Gallup, NM 87301-6137
Phone (505) 863-3828
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 |
|---|---|---|---|
| M-06437 | NM | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215648000000",
"number": "1104979319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 S PUERCO DR",
"city": "GALLUP",
"state": "NM",
"postal_code": "873016137",
"telephone_number": "505-863-3828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "607 S PUERCO DR",
"city": "GALLUP",
"state": "NM",
"postal_code": "873016137",
"telephone_number": "505-863-3828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "AUDNI",
"middle_name": "GENEVIEVE",
"name_prefix": "Dr.",
"credential": "PH. D. LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-19",
"last_updated": "2008-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "M-06437",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gallup, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.