Individual provider Active NPI

Christopher P Miller, LPC

  • Professional Counselor
  • Roanoke, VA
National Provider Identifier
1417229550
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701005183 Issued in VA
Practice address
5401 Fallowater LN
Roanoke, VA 24018-0948
Phone
(434) 485-8861
Fax
(434) 485-8877
NPI assigned
Feb 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701005183 VA Primary

Addresses

Primary practice location

5401 Fallowater LN
Roanoke, VA 24018-0948

Mailing address

739 River Glen Dr
O Fallon, MO 63368-9647
Phone (540) 797-4562

Other practice location 1

739 River Glen Dr
O Fallon, MO 63368-9647
Phone (540) 797-4562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20240806002853 MO Practitioner - Mental Health Counselor 8527505734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tim Bizelli Counseling LLCGroup PAC ID 8820535081, 4 clinicians

Practice addresses (Care Compare)

5933 S Hwy 94
Suite 101
Weldon Spring, MO 63304-5608
Phone (636) 345-1106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0701005183VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tim Bizelli Counseling LLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

5933 S Highway 94
Ste 101
Weldon Spring, MO 63304
Phone (636) 345-1106

Organizations & group practices 1

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": "1328486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1417229550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 RIVER GLEN DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633689647",
            "telephone_number": "540-797-4562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 FALLOWATER LN",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180948",
            "telephone_number": "434-485-8861",
            "fax_number": "434-485-8877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "739 River Glen Dr",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "MO",
            "postal_code": "633689647",
            "country_code": "US",
            "telephone_number": "540-797-4562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CHRISTOPHER",
        "middle_name": "P",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-06",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701005183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.