Active NPI
Bradley A Miller, M.A. LMSW QSUDP
- Social Worker
- Garden City, ID
National Provider Identifier
1710358486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LMSW-34787
- Practice address
- 5583 N Glenwood St
Garden City, ID 83714-1336 - Phone
- (208) 287-2564
- NPI assigned
- Oct 7, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LMSW-34787 | ID | Primary |
Addresses
Primary practice location
5583 N Glenwood St
Garden City, ID 83714-1336
Mailing address
5583 N Glenwood St
Garden City, ID 83714-1336
Phone (208) 287-2564
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-34787 | ID | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444176000000",
"number": "1710358486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5583 N GLENWOOD ST",
"city": "GARDEN CITY",
"state": "ID",
"postal_code": "837141336",
"telephone_number": "208-287-2564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5583 N GLENWOOD ST",
"city": "GARDEN CITY",
"state": "ID",
"postal_code": "837141336",
"telephone_number": "208-287-2564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "BRADLEY",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "M.A. LMSW QSUDP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-10-07",
"last_updated": "2015-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "LMSW-34787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden City, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.