Individual provider Active NPI

Jill C. Miller, MSW, LISW-S

  • Clinical Social Worker
  • Canton, OH
National Provider Identifier
1447576129
Registry record updated Oct 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0800419-SUPV Issued in OH
Practice address
625 Cleveland Ave NW
Canton, OH 44702-1805
Phone
(330) 455-0374
Fax
(330) 455-2101
NPI assigned
Apr 20, 2010
Sex
Female
Sole proprietor
No

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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Central Missouri Mental Health Center 13 clinicians
Sondermind Provider Network LLC 1,295 clinicians

Practice addresses (Care Compare)

1601 E 28TH St
Trenton, MO 64683-1178
Phone (660) 359-4487

1910 Towne Centre Blvd
Suite 250
Annapolis, MD 21401-3599
Phone (866) 630-0966

20 E Thomas Rd
Suite 2200
Phoenix, AZ 85012-3133
Phone (866) 630-0966

20 S 3Rd St
Suite 210
Columbus, OH 43215-4206
Phone (866) 630-0966

4625 Lindell Blvd
Suite 200And300
Saint Louis, MO 63108-3725
Phone (866) 630-0966

6975 S Union Park Ctr
Suite 600
Midvale, UT 84047-4187
Phone (866) 630-0966

90 Canal St
Suite 4
Boston, MA 02114-2022
Phone (866) 630-0966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MA, AZ, MO, MD, UT6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20140114001545 OH Practitioner - Clinical Social Worker 0143458398 Reassigns benefits to 2 organizations
I20230626002559 MA Practitioner - Clinical Social Worker 0143458398 Reassigns benefits to 1 organization
I20230807000843 AZ Practitioner - Clinical Social Worker 0143458398 Reassigns benefits to 1 organization
I20240429003487 MO Practitioner - Clinical Social Worker 0143458398 Reassigns benefits to 2 organizations
I20260410003919 MD Practitioner - Clinical Social Worker 0143458398 Reassigns benefits to 1 organization
I20260414003135 UT Practitioner - Clinical Social Worker 0143458398 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0800419-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Jan 31, 2023 Accepting new patients
North Central Missouri Mental Health Center CurrentSince Apr 8, 2024 Accepting new patients
North Central Missouri Mental Health Center CurrentSince Apr 8, 2024 Accepting new patients

Locations

20 E Thomas Rd
Ste 2200
Phoenix, AZ 85012
Phone (310) 515-8113

90 Canal St
Ste 4
Boston, MA 02114
Phone (617) 517-4889

1910 Towne Centre Blvd
Ste 250
Annapolis, MD 21401
Phone (202) 596-8891

107 W 9th St
Fl 2
Kansas City, MO 64105
Phone (505) 382-2776

4625 Lindell Blvd
Ste 200300
Saint Louis, MO 63108
Phone (314) 396-7900

1601 E 28th St
Trenton, MO 64683
Phone (660) 359-4487

20 S 3rd St
Ste 210
Columbus, OH 43215
Phone (614) 208-4973

6975 S Union Park Ctr
Ste 600
Midvale, UT 84047
Phone (385) 255-7859

NPPES NPI Registry

Updated by the provider on Oct 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.0800419-SUPV OH Primary

Addresses

Primary practice location

625 Cleveland Ave NW
Canton, OH 44702-1805

Mailing address

625 Cleveland Ave NW
Canton, OH 44702-1805
Phone (330) 455-0374

Other names 1

  • Jill Miller Professional name

NPI Registry JSON

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1447576129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021805",
            "telephone_number": "330-455-0374",
            "fax_number": "330-455-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021805",
            "telephone_number": "330-455-0374",
            "fax_number": "330-455-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JILL",
        "middle_name": "C.",
        "name_prefix": "Mrs.",
        "credential": "MSW, LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0800419-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "MILLER",
            "credential": "LISW-S",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.