Adrienne Jackson Miller

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

116 W Piccadilly St Ste 12
Winchester, VA 22601-3956

Phone

(304) 801-3258

Fax

(304) 362-0025

NPI assigned

Feb 5, 2020

Last updated

Dec 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Adrienne Jackson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mountainside Behavior Analysis Services, LCC

  dba Mountainside ABA

  • Community/Behavioral Health Agency
  • Davis, WV
  • NPI 1225574544
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1679105928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 THISTLE LN",
            "city": "DAVIS",
            "state": "WV",
            "postal_code": "262601104",
            "telephone_number": "304-801-3258",
            "fax_number": "304-362-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W PICCADILLY ST STE 12",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013956",
            "telephone_number": "304-801-3258",
            "fax_number": "304-362-0025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1107 S Davis Ave",
            "address_purpose": "LOCATION",
            "city": "Elkins",
            "state": "WV",
            "postal_code": "262418703",
            "country_code": "US",
            "telephone_number": "304-801-3258",
            "fax_number": "304-362-0025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Thistle Ln",
            "address_purpose": "LOCATION",
            "city": "Davis",
            "state": "WV",
            "postal_code": "262601104",
            "country_code": "US",
            "telephone_number": "304-801-3258",
            "fax_number": "304-362-0025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1614 Locust Ave",
            "address_purpose": "LOCATION",
            "city": "Fairmont",
            "state": "WV",
            "postal_code": "265541319",
            "country_code": "US",
            "telephone_number": "304-801-3258",
            "fax_number": "304-362-0025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ADRIENNE",
        "middle_name": "JACKSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-05",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADRIENNE",
            "last_name": "JACKSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard Emerson Miles II
• Milestone Pediatric Therapy LLC (Milestone Pediatric Therapy)
• Heather Anne Milioti, D.C.
• Patricia Lynn Militello, LPN
• Brandy Moler Millay, NP-C
• Alex Sherwood Miller, M.D.
• Brandon L Miller, PA
• Gwen Miller
• Jennifer R Miller, PA-C
• Justin Miller, PHARMD

• Behavior Analyst in Winchester, VA
• Providers in Winchester, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.