Cortney Anne Miller, LCSW, LCAC

Key facts

NPI

1619201498

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

34005686A (IN)

Practice address

1208 S Bloomington St Ste B
Greencastle, IN 46135-2269

Phone

(919) 600-2778

Fax

(866) 544-8850

NPI assigned

Sep 25, 2009

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 21, 2024.

{
    "created_epoch": "1253836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1619201498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1958 S COUNTY ROAD 400 W",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461358282",
            "telephone_number": "919-600-2778",
            "fax_number": "866-544-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 S BLOOMINGTON ST STE B",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461352269",
            "telephone_number": "919-600-2778",
            "fax_number": "866-544-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CORTNEY",
        "middle_name": "ANNE",
        "credential": "LCSW, LCAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-25",
        "last_updated": "2024-03-21",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87001194A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005686A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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