Individual provider Active NPI

Kristi Michelle Gittner Miller, MA

  • Mental Health Counselor
  • Deland, FL
National Provider Identifier
1497931075
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH9662 Issued in FL
Practice address
121 W Pennsylvania Ave
Deland, FL 32720-3429
Phone
(386) 258-1618
NPI assigned
Jan 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH9662 FL Primary

Addresses

Primary practice location

121 W Pennsylvania Ave
Deland, FL 32720-3429

Mailing address

386 S Atlantic Ave # 208
Ormond Beach, FL 32176-7143
Phone (386) 258-1618

Other practice location 1

4662 Clyde Morris Blvd
Port Orange, FL 32129-7450
Phone (386) 258-1618

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
I20240228004059 FL Practitioner - Mental Health Counselor 7012352131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Counseling Center IncGroup PAC ID 8325370950, 10 clinicians

Practice addresses (Care Compare)

121 W Pennsylvania Ave
Deland, FL 32720-3429
Phone (386) 258-1618

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MH9662FLMDMental Health Counselor

Practice roles (1 of 2)

OrganizationSpecialtyStatusNew patients
Presbyterian Counseling Center Inc Mental Health CurrentSince Jan 24, 2024 Accepting new patients

Locations

430 Braddock Ave
Daytona Beach, FL 32118
Phone (386) 258-1616

121 W Pennsylvania Ave
Deland, FL 32720
Phone (386) 290-6525

105 Amsden Rd
Ormond Beach, FL 32176

386 S Atlantic Ave
Ormond Beach, FL 32176
Phone (240) 731-6929

4662 Clyde Morris Blvd
Port Orange, FL 32129
Phone (386) 451-1008

Networks

  • Freedom Health HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1497931075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "386 S ATLANTIC AVE # 208",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321767143",
            "telephone_number": "386-258-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W PENNSYLVANIA AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203429",
            "telephone_number": "386-258-1618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4662 Clyde Morris Blvd",
            "address_purpose": "LOCATION",
            "city": "Port Orange",
            "state": "FL",
            "postal_code": "321297450",
            "country_code": "US",
            "telephone_number": "386-258-1618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KRISTI",
        "middle_name": "MICHELLE GITTNER",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-14",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH9662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.