Individual provider Active NPI

Jennifer Mary Miller

  • Mental Health Counselor
  • Erie, PA
National Provider Identifier
1609695568
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC017610 Issued in PA
Practice address
650 East Ave
Erie, PA 16503-1524
Phone
(814) 455-5505
Fax
(814) 455-5515
NPI assigned
Oct 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC017610 PA Primary
Professional Counselor 101YP2500X PC017610 PA

Addresses

Primary practice location

650 East Ave
Erie, PA 16503-1524

Mailing address

100 Shenango Ave
Sharon, PA 16146-2102
Phone (814) 455-5505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250710000426 PA Practitioner - Mental Health Counselor 9739693839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Shenango Ave
Sharon, PA 16146-1503

2261 Market St
San Francisco, CA 94114-1612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC017610PAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Network CurrentSince Jan 5, 2026 Accepting new patients
Primary Health Network CurrentSince Jan 5, 2026 Accepting new patients

Locations

650 East Ave
Erie, PA 16503
Phone (814) 455-5505

2000 Green St
Farrell, PA 16121
Phone (724) 342-6600

63 Pitt St
Sharon, PA 16146
Phone (724) 342-6604

100 Shenango Ave
Sharon, PA 16146
Phone (724) 704-8886

120 S Martin St
Titusville, PA 16354
Phone (814) 827-2938

Organizations & group practices 2

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": "1728345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1609695568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SHENANGO AVE",
            "city": "SHARON",
            "state": "PA",
            "postal_code": "161462102",
            "telephone_number": "814-455-5505",
            "fax_number": "814-455-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 EAST AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165031524",
            "telephone_number": "814-455-5505",
            "fax_number": "814-455-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JENNIFER",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-08",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC017610",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC017610",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.