Individual provider Active NPI

Norman Nathaniel Miller Jr., LADAC, NCAC

  • Addiction (Substance Use Disorder) Counselor
  • Memphis, TN
National Provider Identifier
1265607220
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LDC0000000411 Issued in TN
Practice address
1420 Union Ave
Ste. 230
Memphis, TN 38104-3695
Phone
(901) 276-0220
Fax
(901) 276-0225
NPI assigned
Apr 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LDC0000000411 TN Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X NCAC 001390 VA

Addresses

Primary practice location

1420 Union Ave
Ste. 230
Memphis, TN 38104-3695

Mailing address

1420 Union Ave
Ste. 230
Memphis, TN 38104-3695
Phone (901) 276-0220

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
LDC0000000411TNMDAddiction (Substance Use Disorder) Counselor
NCAC 001390VAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Counseling & Consulting PastSince Jan 1, 2000 Accepting new patients

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": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1265607220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 UNION AVE",
            "address_2": "STE. 230",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043695",
            "telephone_number": "901-276-0220",
            "fax_number": "901-276-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 UNION AVE",
            "address_2": "STE. 230",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043695",
            "telephone_number": "901-276-0220",
            "fax_number": "901-276-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "NORMAN",
        "middle_name": "NATHANIEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LADAC, NCAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "LDC0000000411",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "NCAC 001390",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.