Kelly M Miller, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006446 Issued in CT

Practice address

435 Lewis Ave
Meriden, CT 06451-2101

Phone

(203) 284-1340

Fax

(203) 265-4557

NPI assigned

Apr 29, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly Dempster Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• The Griffin Hospital

  • Radiation Oncology Clinic/Center
  • Derby, CT
  • NPI 1154568384
  NPD
• The Griffin Hospital

  • General Acute Care Hospital
  • Derby, CT
  • NPI 1184639973
  NPD
• Midstate Medical Center

  • General Acute Care Hospital
  • Meriden, CT
  • NPI 1427007848
  NPD (past)

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240963200000",
    "number": "1447494844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4131",
            "city": "YALESVILLE",
            "state": "CT",
            "postal_code": "064921481",
            "telephone_number": "203-284-1340",
            "fax_number": "203-265-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 LEWIS AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512101",
            "telephone_number": "203-284-1340",
            "fax_number": "203-265-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-29",
        "last_updated": "2009-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "DEMPSTER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Midstate Vna & Hospice Inc
• Miller Memorial Community, Inc.
• Cheryl Ann Miller, D.C.
• Douglas T Miller, M.D.
• Hillary Miller, DNP
• Shelby Ming, M.A.
• Mubarik N Mir
• Misbah M. Vahidy, MD, PC
• William C Mitchard, DPM
• Satina Mitchell, LCSW

• Clinical Social Worker in Meriden, CT
• Providers in Meriden, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; 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.