NPIMap

Organization Active NPI

Mindy Miller LLC

  • Clinical Social Worker
  • Joplin, MO
National Provider Identifier
1699947820
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MINDY MILLER LLC
Practice address
1505 E 20TH St
Joplin, MO 64804-0928
Phone
(417) 627-9601
Fax
(417) 627-9032
NPI assigned
Mar 27, 2008
Last updated
Mar 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Authorized official

Name
Ms. Mindy J Miller, M.S.W., LCSWNPI 1104902220
Title
Licensed Clinical Social Worker
Phone
(417) 627-9601

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

1505 E 20TH St
Joplin, MO 64804-0928

Mailing address

1505 E 20TH St
Joplin, MO 64804-0928
Phone (417) 627-9601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080415000406 MO Part B Supplier - Clinic/Group Practice 5597843615 Receives reassigned benefits from 1 practitioner
Practice locations: Joplin, MO

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1505 E 20th St
Joplin, MO 64804
Phone (417) 627-9601

1627 W 26th St
Joplin, MO 64804
Phone (417) 627-9601

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1699947820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 E 20TH ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648040928",
            "telephone_number": "417-627-9601",
            "fax_number": "417-627-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 E 20TH ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648040928",
            "telephone_number": "417-627-9601",
            "fax_number": "417-627-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDY MILLER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-27",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MINDY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "417-627-9601",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S.W., LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.