Active NPI
Samantha Miller
- Professional Counselor
- Broomfield, CO
National Provider Identifier
1639567217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPCC.0015805
- Practice address
- 350 Interlocken Blvd
Broomfield, CO 80021-3477 - Phone
- (720) 523-1116
- Fax
- (720) 523-1116
- NPI assigned
- Jan 5, 2015
- Last updated
- Feb 1, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPCC.0015805 | CO | Primary |
| Case Manager/Care Coordinator | 171M00000X | NU |
Addresses
Primary practice location
350 Interlocken Blvd
Broomfield, CO 80021-3477
Mailing address
350 Interlocken Blvd Ste 100
Broomfield, CO 80021-3478
Phone (720) 523-1116
Other practice location 1
11059 E Bethany Dr
Ste 200
Aurora, CO 80014-2622
Phone (303) 617-2300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LPCC.0015805 | Other | CO | NO MEDICAID |
Other names 1
- Samantha Miller
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 |
|---|---|---|---|
| LPCC.0015805 | CO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548979200000",
"number": "1639567217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 INTERLOCKEN BLVD STE 100",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800213478",
"telephone_number": "720-523-1116",
"fax_number": "720-523-1116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 INTERLOCKEN BLVD",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800213477",
"telephone_number": "720-523-1116",
"fax_number": "720-523-1116"
}
],
"practiceLocations": [
{
"address_1": "11059 E Bethany Dr",
"address_2": "STE 200",
"address_purpose": "LOCATION",
"city": "Aurora",
"state": "CO",
"postal_code": "800142622",
"country_code": "US",
"telephone_number": "303-617-2300",
"fax_number": "303-617-2397",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLER",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-05",
"last_updated": "2019-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "LPCC.0015805",
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NO MEDICAID",
"identifier": "LPCC.0015805",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SAMANTHA",
"last_name": "MILLER",
"credential": "LPCC",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.