Active NPI
Theodore Robert Miller, PH.D., HSPP
- Rehabilitation Psychologist
- Marion, IN
National Provider Identifier
1376565796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Psychologist
- License
- 20010382A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20010282A | IN | MD | Psychologist |
| 20010382A | IN | MD | Group 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.