Individual provider Active NPI

Daniel Lester Miller

  • Mental Health Counselor
  • Flushing, NY
National Provider Identifier
1679067540
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
012336 Issued in NY
Practice address
14202 20TH Ave
Flushing, NY 11351-3000
Phone
(718) 559-0555
NPI assigned
Jun 14, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Mental Health Counselor 101YM0800X 012336 NY Primary

Addresses

Primary practice location

14202 20TH Ave
Flushing, NY 11351-3000

Mailing address

14202 20TH Ave
Flushing, NY 11351-3000
Phone (718) 559-0555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250417000218 NY Practitioner - Mental Health Counselor 1557886058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Hofstra North Shore - Lij School of Medicine, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Welllife Network IncGroup PAC ID 0749179570, 17 clinicians

Practice addresses (Care Compare)

3600 Route 112
Coram, NY 11727-4116
Phone (631) 920-8302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Welllife Network Inc. CurrentSince Apr 11, 2025 Accepting new patients
Welllife Network Inc., Current Accepting new patients
Welllife Network Inc CurrentSince Apr 11, 2025 Accepting new patients

Locations

3600 Route 112
Coram, NY 11727
Phone (631) 854-2100

14202 20th Ave
#3
Flushing, NY 11351

14202 20th Ave
Fl 3
Flushing, NY 11351
Phone (718) 559-0516

14202 20th Ave
Flushing, NY 11351
Phone (718) 559-0516

800 Northern Blvd
Great Neck, NY 11021
Phone (516) 829-8450

1985 Marcus Ave
Ste 100
New Hyde Park, NY 11042
Phone (347) 265-9985

20905 Jamaica Ave
Queens Village, NY 11428
Phone (631) 920-8302

Organizations & group practices 3

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": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1679067540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14202 20TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113513000",
            "telephone_number": "718-559-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14202 20TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113513000",
            "telephone_number": "718-559-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "DANIEL",
        "middle_name": "LESTER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-14",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "012336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.