Individual provider Active NPI

Theodore Robert Miller, PH.D., HSPP

  • Rehabilitation Psychologist
  • Marion, IN
National Provider Identifier
1376565796
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PsychologistTaxonomy code 103TR0400X
License
20010382A Issued in IN
Practice address
1700 E 38TH St
Marion, IN 46953-4568
Phone
(765) 674-3321
Fax
(765) 677-5122
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20010282A IN
Addiction (Substance Use Disorder) Psychologist 103TA0400X 20010382A IN
Adult Development & Aging Psychologist 103TA0700X 20010382A IN
Cognitive & Behavioral Psychologist 103TB0200X 20010382A IN
Clinical Psychologist 103TC0700X 20010382A IN
Family Psychologist 103TF0000X 20010382A IN
Health Service Psychologist 103TH0100X 20010382A IN
Psychologist 103T00000X 20010382A IN
Group Psychotherapy Psychologist 103TP2701X 20010382A IN
Rehabilitation Psychologist 103TR0400X 20010382A IN Primary

Addresses

Primary practice location

1700 E 38TH St
Marion, IN 46953-4568

Mailing address

11605 N 100 E
Alexandria, IN 46001-8830
Phone (765) 724-9534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
20010282AINMDPsychologist
20010382AINMDGroup Psychotherapy Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1376565796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11605 N 100 E",
            "city": "ALEXANDRIA",
            "state": "IN",
            "postal_code": "460018830",
            "telephone_number": "765-724-9534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E 38TH ST",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469534568",
            "telephone_number": "765-674-3321",
            "fax_number": "765-677-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "THEODORE",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PH.D., HSPP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20010282A",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "20010382A",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "IN",
            "license": "20010382A",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "IN",
            "license": "20010382A",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20010382A",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "IN",
            "license": "20010382A",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "IN",
            "license": "20010382A",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20010382A",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "IN",
            "license": "20010382A",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "IN",
            "license": "20010382A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IN

Sources for this page

Verify at the official NPI Registry.