Individual provider Active NPI

Carrie Miller

  • Mental Health Counselor
  • Marietta, GA
National Provider Identifier
1629533161
Registry record updated Feb 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
APC006847 Issued in GA
Practice address
4343 Shallowford Rd Ste 4
Marietta, GA 30062-5023
Phone
(678) 694-1573
NPI assigned
Feb 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X APC006847 GA Primary

Addresses

Primary practice location

4343 Shallowford Rd Ste 4
Marietta, GA 30062-5023

Mailing address

702 Pine Bluff CT
Woodstock, GA 30189-7044
Phone (260) 417-5262

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

State licenses

LicenseStateTypeSpecialty
APC006847GAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1629533161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 PINE BLUFF CT",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301897044",
            "telephone_number": "260-417-5262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 SHALLOWFORD RD STE 4",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625023",
            "telephone_number": "678-694-1573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CARRIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-08",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "APC006847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; 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.