Active NPI
Kenneth Eric Miller, PH.D.
- Clinical Psychologist
- Cambridge, MA
National Provider Identifier
1497052526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 9219
- Practice address
- 22 Whitney Ave # 2
Cambridge, MA 02139-4612 - Phone
- (617) 845-0002
- NPI assigned
- Feb 25, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 9219 | MA | Primary |
Addresses
Primary practice location
22 Whitney Ave # 2
Cambridge, MA 02139-4612
Mailing address
18 Whitney Avenue #2
Cambridge, MA 02139-4612
Phone (617) 803-3596
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9219 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298592000000",
"number": "1497052526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 WHITNEY AVENUE #2",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021394612",
"telephone_number": "617-803-3596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 WHITNEY AVE # 2",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021394612",
"telephone_number": "617-845-0002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "KENNETH",
"middle_name": "ERIC",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-25",
"last_updated": "2011-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "9219",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.