Individual provider Active NPI

Kathryn Shakti Miller, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1679604912
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20207 Issued in TX
Practice address
2900 S 1St St Apt 316
Austin, TX 78704-6369
Phone
(512) 423-9888
Fax
(512) 423-9888
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 20207 TX Primary

Addresses

Primary practice location

2900 S 1St St Apt 316
Austin, TX 78704-6369

Mailing address

2900 S 1St St Apt 316
Austin, TX 78704-6369
Phone (512) 423-9888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20060420000228 TX Practitioner - Clinical Social Worker 5799794616 Practice locations: Austin, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1003 B Beaver TRL
Austin, TX 78746-6603
Phone (512) 328-0814

2900 S 1St St
Apt 316
Austin, TX 78704-6369
Phone (512) 423-9888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20207TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
McKinney Cowan PA 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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1679604912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 S 1ST ST APT 316",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787046369",
            "telephone_number": "512-423-9888",
            "fax_number": "512-423-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S 1ST ST APT 316",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787046369",
            "telephone_number": "512-423-9888",
            "fax_number": "512-423-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KATHRYN",
        "middle_name": "SHAKTI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "20207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.