Individual provider Active NPI

Virginia Ann Miller, LCSW

  • Clinical Social Worker
  • Red Hook, NY
National Provider Identifier
1417008822
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
070188-1 Issued in NY
Practice address
7481 S Broadway
Suite 2B
Red Hook, NY 12571-1780
Phone
(845) 758-2080
NPI assigned
Jan 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 070188-1 NY Primary

Addresses

Primary practice location

7481 S Broadway
Suite 2B
Red Hook, NY 12571-1780

Mailing address

7481 S Broadway
Suite 2B
Red Hook, NY 12571-1780
Phone (845) 758-2080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 4, 2022 through Jan 4, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
070188-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417008822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7481 S BROADWAY",
            "address_2": "SUITE 2B",
            "city": "RED HOOK",
            "state": "NY",
            "postal_code": "125711780",
            "telephone_number": "845-758-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7481 S BROADWAY",
            "address_2": "SUITE 2B",
            "city": "RED HOOK",
            "state": "NY",
            "postal_code": "125711780",
            "telephone_number": "845-758-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "VIRGINIA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "070188-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Hook, NY

Sources for this page

Verify at the official NPI Registry.