Individual provider Active NPI

Susan Ann Miller, LCSW, LSCSW, ACSW

  • Clinical Social Worker
  • Kansas City, MO
National Provider Identifier
1639489784
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2001001529 Issued in MO
Practice address
2405 Elmwood Ave
Kansas City, MO 64127-4536
Phone
(816) 241-5252
NPI assigned
Oct 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2001001529 MO Primary
Clinical Social Worker 1041C0700X 1384 KS

Addresses

Primary practice location

2405 Elmwood Ave
Kansas City, MO 64127-4536

Mailing address

1740 Jefferson St
Kansas City, MO 64108-1104
Phone (816) 471-2536

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
1384KSMDClinical Social Worker
2001001529MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mattie Rhodes Memorial Society Clinical Past Accepting new patients

Organizations & group practices 1

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": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286409600000",
    "number": "1639489784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 JEFFERSON ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641081104",
            "telephone_number": "816-471-2536",
            "fax_number": "816-471-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 ELMWOOD AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641274536",
            "telephone_number": "816-241-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SUSAN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW, LSCSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2010-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2001001529",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "1384",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; 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.