Active NPI
Kimberly Ann Miller, M.A. C.L.
- Mental Health Counselor
- Everett, WA
National Provider Identifier
1841676004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 60418796
- Practice address
- 3422 Broadway
Everett, WA 98201-5024 - Phone
- (425) 312-3137
- NPI assigned
- Aug 10, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 60418796 | WA | Primary |
Addresses
Primary practice location
3422 Broadway
Everett, WA 98201-5024
Mailing address
3422 Broadway
Everett, WA 98201-5024
Phone (425) 312-3137
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60418796 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439164800000",
"number": "1841676004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3422 BROADWAY",
"city": "EVERETT",
"state": "WA",
"postal_code": "982015024",
"telephone_number": "425-312-3137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3422 BROADWAY",
"city": "EVERETT",
"state": "WA",
"postal_code": "982015024",
"telephone_number": "425-312-3137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"credential": "M.A. C.L.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-10",
"last_updated": "2015-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "60418796",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.