Individual provider Active NPI

Jessica Miller, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1134447154
Registry record updated May 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R069586 Issued in NY
Practice address
201 E 37TH St
Aprt 15D-E
New York, NY 10016-3159
Phone
(917) 861-6792
Fax
(212) 792-6058
NPI assigned
May 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2010

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 R069586 NY Primary

Addresses

Primary practice location

201 E 37TH St
Aprt 15D-E
New York, NY 10016-3159

Mailing address

201 E 37TH St
Aprt 15D-E
New York, NY 10016-3159
Phone (917) 861-6792

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

LicenseStateTypeSpecialty
R069586NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273795200000",
    "number": "1134447154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 37TH ST",
            "address_2": "APRT 15D-E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163159",
            "telephone_number": "917-861-6792",
            "fax_number": "212-792-6058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 37TH ST",
            "address_2": "APRT 15D-E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163159",
            "telephone_number": "917-861-6792",
            "fax_number": "212-792-6058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-14",
        "last_updated": "2010-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R069586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2010; 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.