Individual provider Active NPI

Brian Edward Miller, LPCC

  • Professional Counselor
  • Albuquerque, NM
National Provider Identifier
1477801793
Registry record updated Aug 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0151561 Issued in NM
Practice address
1400 Carlisle Blvd NE
Suite B
Albuquerque, NM 87110-5658
Phone
(505) 271-6630
Fax
(505) 271-6442
NPI assigned
Aug 16, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2012

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 0151561 NM
Professional Counselor 101YP2500X 0151561 NM Primary

Addresses

Primary practice location

1400 Carlisle Blvd NE
Suite B
Albuquerque, NM 87110-5658

Mailing address

1400 Carlisle Blvd NE
Suite B
Albuquerque, NM 87110-5658
Phone (505) 271-6630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20240119000029 NM Practitioner - Mental Health Counselor 1254783848 Practice locations: Albuquerque, NM

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1400 Carlisle Blvd NE
Suite 1
Albuquerque, NM 87110-5667
Phone (505) 271-6630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0151561NMMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345075200000",
    "number": "1477801793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 CARLISLE BLVD NE",
            "address_2": "SUITE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105658",
            "telephone_number": "505-271-6630",
            "fax_number": "505-271-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 CARLISLE BLVD NE",
            "address_2": "SUITE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105658",
            "telephone_number": "505-271-6630",
            "fax_number": "505-271-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BRIAN",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-16",
        "last_updated": "2012-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0151561",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0151561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.