Individual provider Active NPI

Rena Lee Miller, PHD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1700484623
Registry record updated Aug 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
023934 Issued in NY
Practice address
447 Broadway FL 2
New York, NY 10013-2562
Phone
(347) 948-3362
NPI assigned
Oct 13, 2020
Last updated
Aug 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 023934 NY Primary

Addresses

Primary practice location

447 Broadway FL 2
New York, NY 10013-2562

Mailing address

82 Nassau St # 60547
New York, NY 10038-3703
Phone (347) 948-3362

Other practice location 1

941 Boulevard E
Weehawken, NJ 07086-7139
Phone (347) 948-3362

Other names 1

  • Dr. Racheli Miller Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Sep 12, 2021 through Sep 12, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Racheli Miller PHD Inc Clinical Current Accepting new patients
Dr Rena Miller Psychological Services LLC Clinical CurrentSince Mar 17, 2024 Accepting new patients
Dr. Miller Psychological Services PLLC Current Accepting new patients

Locations

447 Broadway
Fl 2
New York, NY 10013
Phone (347) 807-3288

82 Nassau St
New York, NY 10038
Phone (347) 625-3993

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630108800000",
    "number": "1700484623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 NASSAU ST # 60547",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100383703",
            "telephone_number": "347-948-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 BROADWAY FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100132562",
            "telephone_number": "347-948-3362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "941 Boulevard E",
            "address_purpose": "LOCATION",
            "city": "Weehawken",
            "state": "NJ",
            "postal_code": "070867139",
            "country_code": "US",
            "telephone_number": "347-948-3362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "RENA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2021-08-28",
        "certification_date": "2021-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "023934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHELI",
            "last_name": "MILLER",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.