Individual provider Active NPI

Mary Elizabeth Miley, MSW, LCSW, CSSW

  • Clinical Social Worker
  • New Britain, CT
National Provider Identifier
1619267440
Registry record updated Apr 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006959 Issued in CT
Practice address
92 Vine St
92 Vine Street
New Britain, CT 06052-1433
Phone
(860) 229-4830
Fax
(860) 826-8701
NPI assigned
Apr 13, 2011
Last updated
Apr 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 006959 CT Primary

Addresses

Primary practice location

92 Vine St
92 Vine Street
New Britain, CT 06052-1433

Mailing address

92 Vine St
92 Vine Street
New Britain, CT 06052-1433
Phone (860) 229-4830

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
006959CTMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1619267440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 VINE ST",
            "address_2": "92 VINE STREET",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060521433",
            "telephone_number": "860-229-4830",
            "fax_number": "860-826-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 VINE ST",
            "address_2": "92 VINE STREET",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060521433",
            "telephone_number": "860-229-4830",
            "fax_number": "860-826-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILEY",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW, CSSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-13",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Britain, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.