Individual provider Active NPI

Nancy Ann Miller, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1740518687
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
18573 Issued in MN
Practice address
4123 E Lake St
Minneapolis, MN 55406-2255
Phone
(612) 728-2061
Fax
(612) 729-2616
NPI assigned
Dec 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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 18573 MN Primary

Addresses

Primary practice location

4123 E Lake St
Minneapolis, MN 55406-2255

Mailing address

1401 East First Street
Duluth, MN 55805
Phone (218) 728-4404

Other names 1

  • Nancy White Former name

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
18573MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Family Partnership Past Accepting new patients

Organizations & group practices 1

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": "1259884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1740518687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 EAST FIRST STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "55805",
            "telephone_number": "218-728-4404",
            "fax_number": "218-728-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 E LAKE ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062255",
            "telephone_number": "612-728-2061",
            "fax_number": "612-729-2616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "NANCY",
        "middle_name": "ANN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-04",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "18573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "WHITE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.