Individual provider Active NPI

Kirsten Miller, MSW, LCSW

  • Clinical Social Worker
  • Madison, WI
National Provider Identifier
1114159266
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8603-123 Issued in WI
Practice address
715 Hill St Ste 140
Madison, WI 53705-3572
Phone
(608) 235-3009
Fax
(608) 305-8736
NPI assigned
Aug 21, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CSW004141 GA
Clinical Social Worker 1041C0700X CSW004141 GA
Clinical Social Worker 1041C0700X 8603 WI
Clinical Social Worker 1041C0700X 8603-123 WI Primary

Addresses

Primary practice location

715 Hill St Ste 140
Madison, WI 53705-3572

Mailing address

715 Hill St Ste 140
Madison, WI 53705-3572
Phone (608) 235-3009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20161028000585 WI Practitioner - Clinical Social Worker 2860535028 Reassigns benefits to 1 organization
Practice locations: Madison, WI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

715 Hill St
Suite 140
Madison, WI 53705-3572
Phone (608) 235-3009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Therapy Center of Madison, Inc. Clinical CurrentSince Jul 31, 2017 Accepting new patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients
Peter C. Jackson, PSYD Consulting, SC CurrentSince Jul 31, 2017 Accepting new patients
University of Wisconsin System Non Payroll Past Accepting new patients
University of Wisconsin Medical Foundation Inc Past Accepting new patients

Locations

700 Ray O Vac Dr
Ste 220
Madison, WI 53711
Phone (608) 276-9191

Interoperability endpoints

  • Direct secure messaging: kirstenmiller@tdh.allscriptsdirect.net

Organizations & group practices 5

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": "1250812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1114159266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 HILL ST STE 140",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053572",
            "telephone_number": "608-235-3009",
            "fax_number": "608-305-8736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 HILL ST STE 140",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053572",
            "telephone_number": "608-235-3009",
            "fax_number": "608-305-8736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KIRSTEN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-21",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "CSW004141",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004141",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8603",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8603-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.