Active NPI
Patricia Kinsey Miller, MA
- Mental Health Counselor
- Dallas, OR
National Provider Identifier
1487877601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 182 SW Academy St Ste 304
Dallas, OR 97338-1900 - Phone
- (503) 623-9289
- Fax
- (503) 831-1726
- NPI assigned
- Apr 10, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
182 SW Academy St Ste 304
Dallas, OR 97338-1900
Mailing address
PO Box 5565
Salem, OR 97304-0565
Phone (503) 551-4390
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 14, 2025 through Feb 14, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487877601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5565",
"city": "SALEM",
"state": "OR",
"postal_code": "973040565",
"telephone_number": "503-551-4390",
"fax_number": "503-364-3961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "182 SW ACADEMY ST STE 304",
"city": "DALLAS",
"state": "OR",
"postal_code": "973381900",
"telephone_number": "503-623-9289",
"fax_number": "503-831-1726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "PATRICIA",
"middle_name": "KINSEY",
"name_prefix": "Ms.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.