Active NPI
Richard Edwin Miller, L.P.C.
- Mental Health Counselor
- Fort Worth, TX
National Provider Identifier
1124128723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 15174
- Practice address
- 800 8TH Ave Ste 628
Ft Worth, TX 76104 - Phone
- (817) 720-5600
- Fax
- (817) 720-5601
- NPI assigned
- Sep 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 15174 | TX | Primary |
Addresses
Primary practice location
800 8TH Ave Ste 628
Ft Worth, TX 76104
Mailing address
800 8TH Ave Ste 628
Ft Worth, TX 76104-2617
Phone (817) 720-5600
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3789LC | Other | TX | BLUE CROSS & BLUE SHEILD |
| 027896201 | Medicaid | TX | |
| 10008748 | Other | TX | AMERIGROUP |
| 242273000 | Other | TX | MAGELLAN PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240131000113 | TX | Practitioner - Mental Health Counselor | 9931552510 | Practice locations: Fort Worth, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
800 8TH Ave
Suite 628
Fort Worth, TX 76104-2617
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15174 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532304000000",
"number": "1124128723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 8TH AVE STE 628",
"city": "FT WORTH",
"state": "TX",
"postal_code": "761042617",
"telephone_number": "817-720-5600",
"fax_number": "817-720-5601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 8TH AVE STE 628",
"city": "FT WORTH",
"state": "TX",
"postal_code": "76104",
"telephone_number": "817-720-5600",
"fax_number": "817-720-5601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "RICHARD",
"middle_name": "EDWIN",
"credential": "L.P.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-23",
"last_updated": "2018-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "15174",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHEILD",
"identifier": "3789LC",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "027896201",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "10008748",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN PROVIDER NUMBER",
"identifier": "242273000",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.