Individual provider Active NPI

Ingrid L Miller, LISW-CP

  • Clinical Social Worker
  • Greenville, SC
National Provider Identifier
1447548672
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8603 Issued in SC
Practice address
130 Mallard St
Greenville, SC 29601-4046
Phone
(864) 233-1534
Fax
(864) 233-3403
NPI assigned
Jul 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8603 SC
Clinical Social Worker 1041C0700X 8603 SC Primary

Addresses

Primary practice location

130 Mallard St
Greenville, SC 29601-4046

Mailing address

PO Box 287
Greenville, SC 29602-0287
Phone (864) 233-1534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20110906000105 SC Practitioner - Clinical Social Worker 8224208004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Psychiatric Service PAGroup PAC ID 1355245440, 12 clinicians

Practice addresses (Care Compare)

2094 Woodruff Rd
Greenville, SC 29607-5939
Phone (864) 676-9211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8603SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Psychiatric Service PA CurrentSince Jun 1, 2017 Accepting new patients
Charleston Counseling Center PC Mental Health CurrentSince Dec 26, 2023 Accepting new patients
Myrtle Beach Counseling Center Mental Health PastSince Aug 6, 2019 Accepting new patients
New Horizon Family Health Services Inc Past Accepting new patients

Locations

2094 Woodruff Rd
Greenville, SC 29607
Phone (864) 676-9211

30 Patewood Dr
Ste 160
Greenville, SC 29615
Phone (864) 455-5777

871 Lowcountry Blvd
Ste 200
Mt Pleasant, SC 29464
Phone (253) 346-0137

Organizations & group practices 4

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": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1447548672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 287",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296020287",
            "telephone_number": "864-233-1534",
            "fax_number": "864-233-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MALLARD ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296014046",
            "telephone_number": "864-233-1534",
            "fax_number": "864-233-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "INGRID",
        "middle_name": "L",
        "credential": "LISW-CP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "8603",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "8603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.