Ayisha R Miller, MS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

1312 Donaghey Ave
Conway, AR 72034-3807

Phone

(501) 366-3600

NPI assigned

Oct 4, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ayisha Kellybrew Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Conway Counseling & Psychological Services, PLLC

  • Professional Counselor
  • Conway, AR
  • NPI 1528454139
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1275628281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 DONAGHEY AVE",
            "address_2": "SUITE 1",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343807",
            "telephone_number": "501-336-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 DONAGHEY AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343807",
            "telephone_number": "501-366-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "AYISHA",
        "middle_name": "R",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "P0409039",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AYISHA",
            "last_name": "KELLYBREW",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Middleton, MD
• Midstate Med-Care, Inc.
• Mike S McFarland Mdpa
• Terry Todd Milam, CRNA
• Milestones Services, Inc.
• Brittney Miller, RBT
• Brooke Alexander Miller
• Krystine D Miller, APRN
• Lexi Nicole Miller
• Natalie Miller

• Professional Counselor in Conway, AR
• Providers in Conway, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; 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.