Active NPI
Donna J Miller
- Addiction (Substance Use Disorder) Counselor
- Mattapan, MA
National Provider Identifier
1417469750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1131
- Practice address
- 201 River St
Mattapan, MA 02126-2713 - Phone
- (617) 534-6187
- Fax
- (857) 288-6679
- NPI assigned
- Oct 26, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1131 | MA | Primary |
Addresses
Primary practice location
201 River St
Mattapan, MA 02126-2713
Mailing address
1010 Massachusetts Ave
Boston, MA 02118-2600
Phone (617) 419-3408
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1131 | MA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508976000000",
"number": "1417469750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 MASSACHUSETTS AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182600",
"telephone_number": "617-419-3408",
"fax_number": "617-534-2611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 RIVER ST",
"city": "MATTAPAN",
"state": "MA",
"postal_code": "021262713",
"telephone_number": "617-534-6187",
"fax_number": "857-288-6679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "DONNA",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-26",
"last_updated": "2017-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MA",
"license": "1131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mattapan, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.