Individual provider Active NPI

Enid Laurie Miller, LCSW

  • Clinical Social Worker
  • Little Neck, NY
National Provider Identifier
1124057575
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R-051207-1 Issued in NY
Practice address
5928 Little Neck Pkwy
Little Neck, NY 11362-2532
Phone
(718) 224-0566
Fax
(718) 224-7544
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R-051207-1 NY Primary

Addresses

Primary practice location

5928 Little Neck Pkwy
Little Neck, NY 11362-2532

Mailing address

961 Crestview Ave
North Woodmere, NY 11581-3142
Phone (718) 224-0566

Other identifiers 1

IdentifierTypeStateIssuer
01382663MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20051208000634 NY Practitioner - Clinical Social Worker 0143241992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samuel Field YmandywhaGroup PAC ID 9537154638, 18 clinicians

Practice addresses (Care Compare)

5928 Little Neck Pkwy
Little Neck, NY 11362-2532
Phone (718) 224-0566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R-051207-1NYMDClinical Social Worker
051207NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel Field Ym&Ywha CurrentSince Dec 1, 2005 Accepting new patients
United Cerebral Palsy Assoc of Nys Inc. Past Accepting new patients
Karat Health, Inc. PastSince Dec 1, 2005 Accepting new patients

Locations

5928 Little Neck Pkwy
Little Neck, NY 11362
Phone (347) 306-0767

5820 Little Neck Pkwy
Little Neck, NY 11362
Phone 64651875842001

Organizations & group practices 3

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1124057575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 CRESTVIEW AVE",
            "city": "NORTH WOODMERE",
            "state": "NY",
            "postal_code": "115813142",
            "telephone_number": "718-224-0566",
            "fax_number": "718-224-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5928 LITTLE NECK PKWY",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113622532",
            "telephone_number": "718-224-0566",
            "fax_number": "718-224-7544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ENID",
        "middle_name": "LAURIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R-051207-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01382663",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Neck, NY

Sources for this page

Verify at the official NPI Registry.