Susanna Miller-Pence, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW28260 Issued in CA

Practice address

Highway 1
San Luis Obispo, CA 93409-8101

Phone

(805) 547-7900

NPI assigned

Jun 10, 2006

Last updated

Oct 24, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Corrections and Rehabilitation-Headquarters

  dba California Men's Colony Mental Health Crisis Bed Pharmacy

  • Pharmacy
  • San Luis Obispo, CA
  • NPI 1023644580
  NPD (past)
• Corrections and Rehabilitation-Headquarters

  dba California Mens Colony Pharmacy

  • Pharmacy
  • San Luis Obispo, CA
  • NPI 1356976252
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1265474977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALIFORNIA MENS COLONY",
            "address_2": "P.O.BOX 8101",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934098101",
            "telephone_number": "805-547-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 1",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934098101",
            "telephone_number": "805-547-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER-PENCE",
        "first_name": "SUSANNA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0370701",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW6435",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW28260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P27744",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Michels
• Mick S. Meiselman, M.D., Professional Corporation
• Heidi M Mikel, MSW
• Natalie Mikkelsen, OTR/L
• Bradley Milde, D.M.D., D.H.SC.
• Ashlee Miller
• Austin Miller, ASW
• Bret Delane Miller
• Bruce David Miller, RPH
• Ceirra Miller

• Clinical Social Worker in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.