Individual provider Active NPI

Kailyn Renee Miller, CDCA.190870

  • Addiction (Substance Use Disorder) Counselor
  • Louisville, OH
National Provider Identifier
1215745336
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.190870 Issued in OH
Practice address
908 Richards Dr
Louisville, OH 44641-2646
Phone
(330) 614-9188
NPI assigned
Dec 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.190870 OH Primary

Addresses

Primary practice location

908 Richards Dr
Louisville, OH 44641-2646

Mailing address

908 Richards Dr
Louisville, OH 44641-2646
Phone (330) 614-9188

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
CDCA.190870OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1734652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1215745336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 RICHARDS DR",
            "city": "LOUISVILLE",
            "state": "OH",
            "postal_code": "446412646",
            "telephone_number": "330-614-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 RICHARDS DR",
            "city": "LOUISVILLE",
            "state": "OH",
            "postal_code": "446412646",
            "telephone_number": "330-614-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KAILYN",
        "middle_name": "RENEE",
        "credential": "CDCA.190870",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-20",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.190870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.