Individual provider Active NPI

Kathryn Elizabeth Miller, PSYCHOLOGIST

  • Psychologist
  • Charlotte, NC
National Provider Identifier
1285174789
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
103496 Issued in NC
Practice address
15801 Brixham Hill Ave Ste 475
Charlotte, NC 28277-0878
Phone
(704) 251-9084
Fax
(877) 513-7720
NPI assigned
Mar 2, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 103496 NC
Psychologist 103T00000X 103496 NC Primary

Addresses

Primary practice location

15801 Brixham Hill Ave Ste 475
Charlotte, NC 28277-0878

Mailing address

15801 Brixham Hill Ave Ste 475
Charlotte, NC 28277-0878
Phone (704) 251-9084

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
103496NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Carolinas PLLC Psychologist CurrentSince Nov 1, 2023 Accepting new patients

Locations

15801 Brixham Hill Ave
Ste 475
Charlotte, NC 28277
Phone (704) 251-9084

7301 Carmel Executive Park Dr
Ste 302
Charlotte, NC 28226
Phone (704) 251-9084

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": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1285174789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15801 BRIXHAM HILL AVE STE 475",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282770878",
            "telephone_number": "704-251-9084",
            "fax_number": "877-513-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15801 BRIXHAM HILL AVE STE 475",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282770878",
            "telephone_number": "704-251-9084",
            "fax_number": "877-513-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-02",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "103496",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "103496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.