Kelley Noelle Miller

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

L2437424 Issued in MI

Practice address

4676 Riverview Dr
Waterford, MI 48329-3764

Phone

(248) 762-7389

NPI assigned

Jun 17, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Judson Center IncGroup PAC ID 5698906907, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Judson Center, Inc.

  • Community/Behavioral Health Agency
  • Royal Oak, MI
  • NPI 1033264890
  Medicare reassignment Care Compare group NPD
• County of Macomb

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clinton TWP, MI
  • NPI 1942532197
  Medicare reassignment NPD
• County of Macomb

  • Public Health or Welfare Agency
  • Mount Clemens, MI
  • NPI 1760462253
  NPD
• Judson Center, Inc.

  • Family Medicine Physician
  • Warren, MI
  • NPI 1396217600
  NPD

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1699114207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4676 RIVERVIEW DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483293764",
            "telephone_number": "248-762-7389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4676 RIVERVIEW DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483293764",
            "telephone_number": "248-762-7389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KELLEY",
        "middle_name": "NOELLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "L2437424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LLPC",
            "identifier": "6401013280",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miller Chiropractic Life Center, P.L.L.C.
• Bridget Miller
• Faith E Miller
• Jeffrey W. Miller, DDS
• Jordon Miller
• Larry Lee Miller, D.C.
• Shawn Daniel Miller, M.A.
• Hailey Milner
• Seyedeh Moniba Mirkhani
• Tyanne Lynn Miskov, MA, LLP, CAADC

• Professional Counselor in Waterford, MI
• Providers in Waterford, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.