Individual provider Active NPI

Shayla Miller

  • Marriage & Family Therapist
  • Woodbury, NJ
National Provider Identifier
1649044926
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
37FA00038200 Issued in NJ
Practice address
1 Lupton Ave # 08096
Woodbury, NJ 08096-5901
Phone
(856) 693-5775
NPI assigned
Nov 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 37FA00038200 NJ Primary

Addresses

Primary practice location

1 Lupton Ave # 08096
Woodbury, NJ 08096-5901

Mailing address

20 Brace Rd Ste 202
Cherry Hill, NJ 08034-2634
Phone (856) 522-4061

Other practice location 1

20 Brace Rd Ste 202
Cherry Hill, NJ 08034-2634
Phone (856) 522-4061

Other identifiers 1

IdentifierTypeStateIssuer
0991317MedicaidNJ

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
37FA00038200NJMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Institute for Relational Wellness CurrentSince Nov 1, 2023 Accepting new patients

Locations

20 Brace Rd
Ste 202
Cherry Hill, NJ 08034
Phone (856) 522-4061

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": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1649044926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BRACE RD STE 202",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342634",
            "telephone_number": "856-522-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LUPTON AVE # 08096",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080965901",
            "telephone_number": "856-693-5775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Brace Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080342634",
            "country_code": "US",
            "telephone_number": "856-522-4061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SHAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-08",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NJ",
            "license": "37FA00038200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0991317",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.