Individual provider Active NPI

Michelle Miller

  • Clinical Social Worker
  • Hampton, VA
National Provider Identifier
1275993842
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904002934 Issued in VA
Practice address
2202 Executive Dr
Suite C
Hampton, VA 23666-6604
Phone
(757) 827-7707
Fax
(757) 838-2573
NPI assigned
Feb 25, 2016
Last updated
Feb 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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 0904002934 VA Primary

Addresses

Primary practice location

2202 Executive Dr
Suite C
Hampton, VA 23666-6604

Mailing address

2202 Executive Dr
Suite C
Hampton, VA 23666-6604
Phone (757) 827-7707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: No
  • 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
I20160502000449 VA Practitioner - Clinical Social Worker 3375842040 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Counseling Center, Inc. Clinical CurrentSince Mar 1, 2016 Accepting new patients

Locations

2202 Executive Dr
Ste C
Hampton, VA 23666
Phone (757) 838-5055

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, 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": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1275993842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 EXECUTIVE DR",
            "address_2": "SUITE C",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666604",
            "telephone_number": "757-827-7707",
            "fax_number": "757-838-2573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 EXECUTIVE DR",
            "address_2": "SUITE C",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666604",
            "telephone_number": "757-827-7707",
            "fax_number": "757-838-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-25",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904002934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.