Individual provider Active NPI

Teresa Iristine Miller, M.S., MCAP, RMHCI

  • Addiction (Substance Use Disorder) Counselor
  • Delray Beach, FL
National Provider Identifier
1679924609
Registry record updated Jul 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
ADC-011530-2015 Issued in FL
Practice address
1200 NW 17TH Ave
Suite 1
Delray Beach, FL 33445-2503
Phone
(561) 265-5453
Fax
(561) 265-5463
NPI assigned
Jun 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X ADC-011530-2015 FL Primary
Mental Health Counselor 101YM0800X IMH 6973 FL

Addresses

Primary practice location

1200 NW 17TH Ave
Suite 1
Delray Beach, FL 33445-2503

Mailing address

1200 NW 17TH Ave
Suite 1
Delray Beach, FL 33445-2503
Phone (561) 265-5453

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
ADC-011530-2015FLMDAddiction (Substance Use Disorder) Counselor
IMH 6973FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
WTJ and Associates Mental Health 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": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467331200000",
    "number": "1679924609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 NW 17TH AVE",
            "address_2": "SUITE 1",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334452503",
            "telephone_number": "561-265-5453",
            "fax_number": "561-265-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NW 17TH AVE",
            "address_2": "SUITE 1",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334452503",
            "telephone_number": "561-265-5453",
            "fax_number": "561-265-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "TERESA",
        "middle_name": "IRISTINE",
        "credential": "M.S., MCAP, RMHCI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "ADC-011530-2015",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH 6973",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2016; 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.