Individual provider Active NPI

Victoria E Miller, LCSW

  • Clinical Social Worker
  • Destin, FL
National Provider Identifier
1245253558
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 6416 Issued in FL
Practice address
225 Main St Ste 7a
Destin, FL 32541-2550
Phone
(850) 404-2294
NPI assigned
Jul 26, 2006
Last updated
May 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2022

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 SW 6416 FL Primary

Addresses

Primary practice location

225 Main St Ste 7a
Destin, FL 32541-2550

Mailing address

255 Main St
Ste 7a
Destin, FL 32541-2503
Phone (850) 863-2873

Other practice location 1

304 N Meridian St
Suite 4
Tallahassee, FL 32301-7634
Phone (850) 577-3300

Other practice location 2

7 Vine Ave NE
Fort Walton Beach, FL 32548-5070
Phone (850) 863-2873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20241101000263 TN Practitioner - Clinical Social Worker 4688673536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8012 Burgundy Cir
Chattanooga, TN 37421-1289
Phone (850) 404-2294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 6416FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Psych Solutions Corp Clinical Past Accepting new patients
Hialeah M R I Inc Clinical Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1245253558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 MAIN ST",
            "address_2": "STE 7A",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412503",
            "telephone_number": "850-863-2873",
            "fax_number": "850-689-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MAIN ST STE 7A",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412550",
            "telephone_number": "850-404-2294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "304 N Meridian St",
            "address_2": "Suite 4",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323017634",
            "country_code": "US",
            "telephone_number": "850-577-3300",
            "fax_number": "850-668-5286",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7 Vine Ave NE",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325485070",
            "country_code": "US",
            "telephone_number": "850-863-2873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "VICTORIA",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 6416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Destin, FL

Sources for this page

Verify at the official NPI Registry.