Miranda Rose Roth Millican, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

6543 Bell Bluff Ave
San Diego, CA 92119-1047

Phone

(805) 234-5177

NPI assigned

Sep 12, 2011

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

Other names 1

• Miranda Rose Roth Kelsch Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Miranda Millican Marriage and Family Therapist Inc

  • Mental Health Counselor
  • San Diego, CA
  • NPI 1992460430
  NPD Authorized official
• Psychiatric Centers at San Diego, Inc. Med GRP

  • Mental Health Counselor
  • San Diego, CA
  • NPI 1841241585

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1315785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1801178249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609001",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921609001",
            "telephone_number": "619-528-4600",
            "fax_number": "619-528-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6543 BELL BLUFF AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921191047",
            "telephone_number": "805-234-5177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Spring St",
            "address_2": "#220",
            "address_purpose": "LOCATION",
            "city": "LA Mesa",
            "state": "CA",
            "postal_code": "919420263",
            "country_code": "US",
            "telephone_number": "619-667-3380",
            "fax_number": "619-667-0815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLICAN",
        "first_name": "MIRANDA",
        "middle_name": "ROSE ROTH",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-12",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "KELSCH",
            "middle_name": "ROSE ROTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vera Miller, RN
• Veronica Miller
• William Matthew Miller, SLP
• Miller'S Blueprint Chiropractic, Inc.
• Joanne Millgate
• Ruth L Millican
• Milligan Chiropractic Group Inc
• Brian Patrick Milligan, D.C.
• Jessy Milligan, MFT INTERN
• Lindsey Joann Milligan

• Marriage & Family Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.

Verify at the official NPI Registry.