Individual provider Active NPI

Symone Chermira Miller, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1194270827
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW018453 Issued in PA
Practice address
7782 Crittenden Street
Philadelphia, PA 19118
Phone
(215) 948-6040
NPI assigned
Aug 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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 CW018453 PA Primary

Addresses

Primary practice location

7782 Crittenden Street
Philadelphia, PA 19118

Mailing address

7782 Crittenden Street
PO Box 27083
Philadelphia, PA 19118
Phone (215) 948-6040

Other practice location 1

5517 Crowson Street
Philadelphia, PA 19144
Phone (215) 459-3634

Other practice location 2

8620 Williams Ave
Philadelphia, PA 19150-1919
Phone (215) 459-3634

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW018453PAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1194270827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7782 CRITTENDEN STREET",
            "address_2": "PO BOX 27083",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19118",
            "telephone_number": "215-948-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7782 CRITTENDEN STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19118",
            "telephone_number": "215-948-6040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5517 Crowson Street",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19144",
            "country_code": "US",
            "telephone_number": "215-459-3634",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8620 Williams Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191501919",
            "country_code": "US",
            "telephone_number": "215-459-3634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SYMONE",
        "middle_name": "CHERMIRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.