Individual provider Active NPI

Jennifer Miller, LCSW

  • Clinical Social Worker
  • Avondale, AZ
National Provider Identifier
1790403939
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-19886 Issued in AZ
Practice address
506 E Western Ave Ste 104
Avondale, AZ 85323-2422
Phone
(602) 230-7373
Fax
(602) 230-3086
NPI assigned
Aug 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LCSW-19886 AZ
Clinical Social Worker 1041C0700X LCSW-19886 AZ Primary

Addresses

Primary practice location

506 E Western Ave Ste 104
Avondale, AZ 85323-2422

Mailing address

3101 N Central Ave Ste 550
Phoenix, AZ 85012-2635
Phone (602) 230-7373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220914003372 AZ Practitioner - Clinical Social Worker 7911382718 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-19886AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Denova Collaborative Health, LLC CurrentSince Jun 3, 2022 Accepting new patients
Denova Collaborative Health, LLC Current Accepting new patients
Denova Collaborative Health, LLC CurrentSince Jun 3, 2022 Accepting new patients
Denova Collaborative Health, LLC Past Accepting new patients

Locations

506 E Western Ave
Ste 104
Avondale, AZ 85323

235 W Western Ave
Avondale, AZ 85323
Phone (623) 772-5091

610 E Baseline Rd
Ste 5
Phoenix, AZ 85042

3101 N Central Ave
Ste 550
Phoenix, AZ 85012

3101 N Central Ave
Ste 500
Phoenix, AZ 85012

3330 N 2nd St
Ste 601
Phoenix, AZ 85012
Phone (602) 234-3444

3033 N Central Ave
Ste 700
Phoenix, AZ 85012
Phone (602) 281-7289

Organizations & group practices 4

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": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1790403939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 N CENTRAL AVE STE 550",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122635",
            "telephone_number": "602-230-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 E WESTERN AVE STE 104",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853232422",
            "telephone_number": "602-230-7373",
            "fax_number": "602-230-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LCSW-19886",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-19886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

Verify at the official NPI Registry.