Individual provider Active NPI

Sandra Miller, MSW

  • Professional Counselor
  • Youngstown, OH
National Provider Identifier
1598960536
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
I0005304 Issued in OH
Practice address
142 Javit CT
Youngstown, OH 44515-2409
Phone
(330) 793-2487
Fax
(330) 793-4559
NPI assigned
Jun 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X I0005304 OH Primary

Addresses

Primary practice location

142 Javit CT
Youngstown, OH 44515-2409

Mailing address

142 Javit CT
Youngstown, OH 44515-2409
Phone (330) 793-2487

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20130417000447 OH Practitioner - Clinical Social Worker 1254577232 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0005304OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Family and Community Services CurrentSince Jan 22, 2013 Accepting new patients
Compass Family and Community Services Current Accepting new patients
Comprehensive Psychiatry Specialists Past Accepting new patients

Locations

1960 E County Line Rd
Ste 5
Mineral Ridge, OH 44440

320 High St NE
Warren, OH 44481
Phone (330) 394-9090

535 Marmion Ave
Youngstown, OH 44502
Phone (330) 782-5664

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598960536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 JAVIT CT",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445152409",
            "telephone_number": "330-793-2487",
            "fax_number": "330-793-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 JAVIT CT",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445152409",
            "telephone_number": "330-793-2487",
            "fax_number": "330-793-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SANDRA",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "I0005304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.