Individual provider Active NPI

Vanessa Miller, MA, TLLP

  • Counseling Psychologist
  • Kalamazoo, MI
National Provider Identifier
1417424441
Registry record updated Oct 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
6301017701 Issued in MI
Practice address
6963 W KL Ave Ste a
Kalamazoo, MI 49009-8043
Phone
(269) 459-9790
NPI assigned
Oct 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 6301017701 MI Primary

Addresses

Primary practice location

6963 W KL Ave Ste a
Kalamazoo, MI 49009-8043

Mailing address

4523 W Main St Apt A31
Kalamazoo, MI 49006-2632

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6301017701MIMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dorman and Associates PLC Past Accepting new patients
Meaningful Connections Counseling PLC PastSince Jul 8, 2019 Accepting new patients

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": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1417424441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4523 W MAIN ST APT A31",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490062632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6963 W KL AVE STE A",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490098043",
            "telephone_number": "269-459-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "VANESSA",
        "credential": "MA, TLLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301017701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.