Active NPI
Ken D Miller, PH.D., LPC, NCC
- Mental Health Counselor
- Winder, GA
National Provider Identifier
1508555939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC013568
- Practice address
- 70 Church St
Winder, GA 30680-1714 - Phone
- (770) 789-1477
- NPI assigned
- May 2, 2023
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC013568 | GA | Primary |
Addresses
Primary practice location
70 Church St
Winder, GA 30680-1714
Mailing address
82 W New St
Winder, GA 30680-1848
Phone (770) 789-1477
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 |
|---|---|---|---|
| LPC013568 | GA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682985600000",
"number": "1508555939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "82 W NEW ST",
"city": "WINDER",
"state": "GA",
"postal_code": "306801848",
"telephone_number": "770-789-1477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 CHURCH ST",
"city": "WINDER",
"state": "GA",
"postal_code": "306801714",
"telephone_number": "770-789-1477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "KEN",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "PH.D., LPC, NCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-02",
"last_updated": "2023-05-02",
"certification_date": "2023-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "GA",
"license": "LPC013568",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winder, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.