Individual provider Active NPI

Melissa A Miller, MS, LMHP, LPC

  • Mental Health Counselor
  • Council Bluffs, IA
National Provider Identifier
1174784458
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3369 Issued in NE
Practice address
500 Willow Ave
Suite 305
Council Bluffs, IA 51503-0827
Phone
(712) 256-4420
Fax
(712) 256-4423
NPI assigned
Jun 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3369 NE Primary

Addresses

Primary practice location

500 Willow Ave
Suite 305
Council Bluffs, IA 51503-0827

Mailing address

500 Willow Ave
Suite 305
Council Bluffs, IA 51503-0827
Phone (712) 256-4420

Other identifiers 2

IdentifierTypeStateIssuer
100253517-00MedicaidNE
1010744MedicaidIA

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3369NEMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1174784458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WILLOW AVE",
            "address_2": "SUITE 305",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515030827",
            "telephone_number": "712-256-4420",
            "fax_number": "712-256-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WILLOW AVE",
            "address_2": "SUITE 305",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515030827",
            "telephone_number": "712-256-4420",
            "fax_number": "712-256-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "MS, LMHP, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-19",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100253517-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010744",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.