Derrick James Miller

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801105548 Issued in MI

Practice address

401 Etcheverry St
Ramona, CA 92065-3003

Phone

(313) 618-9762

NPI assigned

Mar 29, 2017

Last updated

Sep 26, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Clinical Social Worker

Education

University of Michigan Medical School, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Derrick Miller PLLC

  • Clinical Social Worker
  • Ramona, CA
  • NPI 1710534789
  Authorized official Same address or phone
• Labyrinth, PLLC.

  • Clinical Social Worker
  • Ramona, CA
  • NPI 1215668488
  Authorized official Same address or phone

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790380800000",
    "number": "1265964209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8231 KENSINGTON BLVD APT 486",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484232935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 ETCHEVERRY ST",
            "city": "RAMONA",
            "state": "CA",
            "postal_code": "920653003",
            "telephone_number": "313-618-9762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42815 Garfield Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Clinton Township",
            "state": "MI",
            "postal_code": "480381143",
            "country_code": "US",
            "telephone_number": "586-333-5328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DERRICK",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-29",
        "last_updated": "2026-09-26",
        "certification_date": "2026-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801105548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marlene Mendoza, DPT
• Mental Health Systems, Inc. (Teen Recovery Center - Ramona)
• Mental Health Systems, Inc. (BPSR Kinesis North - Ramona Clinic)
• Michael T Bowersox MD Inc
• Angie L Miller
• Jennifer Ane Miller, PSY.D.
• Jerry Miller, MD
• Julie A Mills, CADC-CAS
• Mindful Living Psychotherapy
• Mindsmith, a Psychological Professional Corporation (Mindsmith)

• Clinical Social Worker in Ramona, CA
• Providers in Ramona, 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 Sep 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.