Individual provider Active NPI

Elizabeth Susan Miller, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1689986648
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10884 Issued in MD
Practice address
8415 Bellona LN
Suite 201
Baltimore, MD 21204-2055
Phone
(410) 821-7775
Fax
(410) 821-1320
NPI assigned
Jul 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2011

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 10884 MD Primary

Addresses

Primary practice location

8415 Bellona LN
Suite 201
Baltimore, MD 21204-2055

Mailing address

8415 Bellona LN
Suite 201
Baltimore, MD 21204-2055
Phone (410) 821-7775

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
10884MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sheppard Pratt Physicians, P.a. PastSince Jan 1, 1995 Accepting new patients
Nephrology Center of Maryland, PA Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7494/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1689986648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 BELLONA LN",
            "address_2": "SUITE 201",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212042055",
            "telephone_number": "410-821-7775",
            "fax_number": "410-821-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 BELLONA LN",
            "address_2": "SUITE 201",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212042055",
            "telephone_number": "410-821-7775",
            "fax_number": "410-821-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ELIZABETH",
        "middle_name": "SUSAN",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-07",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "10884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; 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.