Active NPI
Mitzi Nicole Miller, MS, CCC-SLP
- Speech-Language Pathologist
- Carencro, LA
National Provider Identifier
1487227575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6108
- Practice address
- 101 Tara Oak Dr
Carencro, LA 70520-5776 - Phone
- (337) 305-3544
- NPI assigned
- Jul 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP12950 | AZ | |
| Speech-Language Pathologist | 235Z00000X | 6108 | LA | Primary |
Addresses
Primary practice location
101 Tara Oak Dr
Carencro, LA 70520-5776
Mailing address
101 Tara Oak Dr
Carencro, LA 70520-5776
Phone (337) 305-3544
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6108 | LA | MD | Professional Counselor |
| SLP12950 | AZ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626652800000",
"number": "1487227575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 TARA OAK DR",
"city": "CARENCRO",
"state": "LA",
"postal_code": "705205776",
"telephone_number": "337-305-3544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 TARA OAK DR",
"city": "CARENCRO",
"state": "LA",
"postal_code": "705205776",
"telephone_number": "337-305-3544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "MITZI",
"middle_name": "NICOLE",
"credential": "MS, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-19",
"last_updated": "2021-07-19",
"certification_date": "2021-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "SLP12950",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "LA",
"license": "6108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carencro, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.