Individual provider Active NPI

Alexandra M Miller

  • Clinical Social Worker
  • Burlington, MA
National Provider Identifier
1184850265
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
116708 Issued in MA
Practice address
20 Wall St
Burlington, MA 01803-4758
Phone
(781) 221-2650
Fax
(781) 221-2510
NPI assigned
Jun 3, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 116708 MA Primary

Addresses

Primary practice location

20 Wall St
Burlington, MA 01803-4758

Mailing address

20 Wall St
Burlington, MA 01803-4758
Phone (781) 221-2650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20120417000417 MA Practitioner - Clinical Social Worker 8527229699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Child and Family Psychological Services PLLCGroup PAC ID 5991763823, 260 clinicians

Practice addresses (Care Compare)

1 Brookline PL
Suite 321
Brookline, MA 02445-7237
Phone (716) 646-0500

2300 Crown Colony Dr
Suite 202
Quincy, MA 02169-0902
Phone (781) 551-0999

288 Walnut St
Suite 220
Newton, MA 02460-1994
Phone (617) 552-5116

89 Access Rd
Suite 24
Norwood, MA 02062-5233
Phone (781) 551-0999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
116708MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC Mental Health CurrentSince May 15, 2020 Accepting new patients

Locations

288 Walnut St
Ste 220
Newtonville, MA 02460
Phone (617) 552-5116

89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040

169 Libbey Park
Weymouth, MA 02189
Phone (508) 238-7766

Organizations & group practices 1

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": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1184850265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 WALL ST",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018034758",
            "telephone_number": "781-221-2650",
            "fax_number": "781-221-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WALL ST",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018034758",
            "telephone_number": "781-221-2650",
            "fax_number": "781-221-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ALEXANDRA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.