Individual provider Active NPI

Nickia M Miller, LADC, LCSW

  • Clinical Social Worker
  • East Hartford, CT
National Provider Identifier
1437514080
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12263 Issued in CT
Practice address
477 Conn Blvd Ste 117
East Hartford, CT 06108-3228
Phone
(860) 838-8140
NPI assigned
Dec 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1121 CT
Mental Health Counselor 101YM0800X 12263 CT
Clinical Social Worker 1041C0700X 12263 CT Primary

Addresses

Primary practice location

477 Conn Blvd Ste 117
East Hartford, CT 06108-3228

Mailing address

477 Connecticut Blvd Ste 117
East Hartford, CT 06108-3228
Phone (860) 838-8140

Other practice location 1

110 National Dr
Glastonbury, CT 06033-4371
Phone (860) 657-8910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20260416002635 CT Practitioner - Clinical Social Worker 8325514466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1290 Silas Deane Hwy
Wethersfield, CT 06109

477 Connecticut Blvd
Suite 117
East Hartford, CT 06108-3228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12263CTMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lemons to Lavender, LLC Addiction (Substance Use Disorder) Current Accepting new patients
Ebony Horsewomen, Inc Past Accepting new patients

Locations

41 Crossroads Plz
West Hartford, CT 06117
Phone (860) 521-9032

Organizations & group practices 3

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": "1451260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1437514080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 CONNECTICUT BLVD STE 117",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083228",
            "telephone_number": "860-838-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 CONN BLVD STE 117",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083228",
            "telephone_number": "860-838-8140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 National Dr",
            "address_purpose": "LOCATION",
            "city": "Glastonbury",
            "state": "CT",
            "postal_code": "060334371",
            "country_code": "US",
            "telephone_number": "860-657-8910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "NICKIA",
        "middle_name": "M",
        "credential": "LADC, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-28",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "1121",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "12263",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "12263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

Verify at the official NPI Registry.