Individual provider Active NPI

Jennifer L Miller, LCSW

  • Clinical Social Worker
  • Covington, KY
National Provider Identifier
1386953255
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3840 Issued in KY
Practice address
502 Farrell Dr
Covington, KY 41011-3717
Phone
(859) 578-3200
NPI assigned
Sep 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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 3840 KY Primary

Addresses

Primary practice location

502 Farrell Dr
Covington, KY 41011-3717

Mailing address

502 Farrell Dr
Covington, KY 41011-3717
Phone (859) 578-3204

Other identifiers 1

IdentifierTypeStateIssuer
61-0661458OtherKYGROUP TAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • 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
I20140114000750 KY Practitioner - Clinical Social Worker 1254569593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

513 Madison Ave
FL 1
Covington, KY 41011-1535
Phone (859) 578-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Kentucky Mental Health Mental Retardation Regional Board CurrentSince Dec 2, 2013 Accepting new patients
Northern Kentucky Mental Health Mental Retardation Regional Board CurrentSince Dec 2, 2013 Accepting new patients

Locations

503 Farrell Dr
Covington, KY 41011
Phone (606) 578-3214

513 Madison Ave
Covington, KY 41011
Phone (859) 291-1121

513 Madison Ave
Fl 1
Covington, KY 41011

502 Farrell Dr
Covington, KY 41011
Phone (859) 578-3204

Organizations & group practices 2

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": "1285545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1386953255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 FARRELL DR",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410113717",
            "telephone_number": "859-578-3204",
            "fax_number": "859-578-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 FARRELL DR",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410113717",
            "telephone_number": "859-578-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-27",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TAX ID",
            "identifier": "61-0661458",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, KY

Sources for this page

Verify at the official NPI Registry.