Active NPI
Leisha Miller, MS
- Mental Health Counselor
- Roseburg, OR
National Provider Identifier
1740603356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2700 Stewart Parkway
Annex B
Roseburg, OR 97471 - Phone
- (541) 440-3532
- Fax
- (541) 440-3554
- NPI assigned
- Feb 3, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2700 Stewart Parkway
Annex B
Roseburg, OR 97471
Mailing address
272 Medical Loop
Suite E
Roseburg, OR 97471
Phone (541) 440-3532
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500668222 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 2, 2025 through Apr 2, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640131200000",
"number": "1740603356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "272 MEDICAL LOOP",
"address_2": "SUITE E",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "97471",
"telephone_number": "541-440-3532",
"fax_number": "541-440-3554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 STEWART PARKWAY",
"address_2": "ANNEX B",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "97471",
"telephone_number": "541-440-3532",
"fax_number": "541-440-3554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "LEISHA",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-03",
"last_updated": "2021-12-22",
"certification_date": "2021-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500668222",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.