Individual provider Active NPI

Audrey Milton Miller, BCBA

  • Behavior Analyst
  • Crestview, FL
National Provider Identifier
1841615309
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-13-13264 Issued in FL
Practice address
851 N Wilson St
Crestview, FL 32536-2639
Phone
(850) 607-6910
Fax
(850) 607-6932
NPI assigned
Feb 20, 2014
Last updated
Oct 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-13-13264 FL Primary

Addresses

Primary practice location

851 N Wilson St
Crestview, FL 32536-2639

Mailing address

7669 Barry CT
Seminole, FL 33772-4926
Phone (727) 742-7872

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum House, Inc Behavior Analyst CurrentSince Jul 17, 2022 Accepting new patients
Exceptional Behavior Consulting, LLC Behavior Analyst Past Accepting new patients

Locations

851 N Wilson St
Crestview, FL 32536
Phone (850) 398-6021

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1841615309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7669 BARRY CT",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337724926",
            "telephone_number": "727-742-7872",
            "fax_number": "877-271-9338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 N WILSON ST",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325362639",
            "telephone_number": "850-607-6910",
            "fax_number": "850-607-6932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "AUDREY",
        "middle_name": "MILTON",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-20",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-13-13264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.