Shawnette Nichole Miller, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW004801 Issued in GA

Practice address

2020 Avalon Pkwy Ste 375
McDonough, GA 30253-3087

Phone

(678) 833-1664

Fax

(678) 604-8585

NPI assigned

Apr 1, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Connect Four Counseling LLC

  • Community/Behavioral Health Agency
  • McDonough, GA
  • NPI 1083086581
  NPD (past) Authorized official

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1790028439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 AVALON PKWY STE 375",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302533087",
            "telephone_number": "678-833-1664",
            "fax_number": "678-604-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 AVALON PKWY STE 375",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302533087",
            "telephone_number": "678-833-1664",
            "fax_number": "678-604-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SHAWNETTE",
        "middle_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-01",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerrica Miles, PA-C
• Milestone Behavioral Health Services LLC
• Denitra Miller, LCSW
• Jeff E Miller, LPC
• Lase Vera Miller
• Sonya Michele Miller, PHARMD
• Victoria Miller, LPC
• Shelley Mills
• Tricia Mills, CADC II
• Mindful Milestones ABA LLC

• Clinical Social Worker in McDonough, GA
• Providers in McDonough, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.