Krystal Miller, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

095148 Issued in NY

Practice address

22137 113TH Dr
Queens Village, NY 11429-2621

Phone

(718) 926-6932

NPI assigned

Apr 17, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1174219646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22137 113TH DR",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292621",
            "telephone_number": "718-926-6932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22137 113TH DR",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114292621",
            "telephone_number": "718-926-6932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KRYSTAL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "095148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael P Ehrenhaus, MD, PC
• Sharly Paul Michael
• Myriam Michel, LPN
• Ryan W Milanovic
• Dorell D Miller-Anderson
• Nikkeba Miller
• Bokhi Min
• Taniya Minhas
• Terry Minott-Williams
• Hasibullah Mir, PHARMD

• Clinical Social Worker in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.