Individual provider Active NPI

Candice Miller, LCSW

  • Clinical Social Worker
  • Miami, FL
National Provider Identifier
1457738502
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW16745 Issued in FL
Practice address
66 W Flagler St Ste 900
Miami, FL 33130-1807
Phone
(904) 349-5616
NPI assigned
Apr 28, 2015
Last updated
Jun 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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 SW16745 FL Primary

Addresses

Primary practice location

66 W Flagler St Ste 900
Miami, FL 33130-1807

Mailing address

4899 Belfort Rd Ste 300
Jacksonville, FL 32256-6033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230215002628 FL Practitioner - Clinical Social Worker 6709258932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emery Milne Psychological Group, LLCGroup PAC ID 1355695669, 10 clinicians

Practice addresses (Care Compare)

165 Wells Rd
Suite 304
Orange Park, FL 32073-3037
Phone (904) 720-4040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Emery Milne Psychological Group, LLC CurrentSince Jan 20, 2023 Accepting new patients

Locations

165 Wells Rd
Ste 304
Orange Park, FL 32073
Phone (904) 720-4040

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1457738502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4899 BELFORT RD STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 W FLAGLER ST STE 900",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331301807",
            "telephone_number": "904-349-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CANDICE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-28",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.