Active NPI
Carrie Miller
- Mental Health Counselor
- Marietta, GA
National Provider Identifier
1629533161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- APC006847
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| APC006847 | GA | MD | Mental 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.