NPIMap

Individual provider Active NPI

Kristin Betha Miller, L.C.S.W.

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1295983070
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
24857 Issued in CA
Practice address
2121 W Temple St
Los Angeles, CA 90026
Phone
(213) 385-5100
NPI assigned
Sep 4, 2008
Last updated
Mar 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 24857 CA
Clinical Social Worker 1041C0700X 24857 CA Primary

Addresses

Primary practice location

2121 W Temple St
Los Angeles, CA 90026

Mailing address

2121 W Temple St
Los Angeles, CA 90026-4915
Phone (213) 385-5100

Other practice location 1

3123 Isabel Drive
Los Angeles, CA 90065
Phone (818) 259-8174

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
24857CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Seneca Family of Agencies Past Accepting new patients
Seneca Family of Agencies Past Accepting new patients
Rocketship Education Wisconsin Inc. Past Accepting new patients
Seneca Center Past Accepting new patients

Organizations & group practices 4

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": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1295983070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 W TEMPLE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900264915",
            "telephone_number": "213-385-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 W TEMPLE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90026",
            "telephone_number": "213-385-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3123 Isabel Drive",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90065",
            "country_code": "US",
            "telephone_number": "818-259-8174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KRISTIN",
        "middle_name": "BETHA",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "24857",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "24857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.