Tara Marie Miller

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801089456 Issued in MI

Practice address

103 W US 2
Gogebic County Community Mental Health
Wakefield, MI 49968-9539

Phone

(906) 229-6120

NPI assigned

Jul 16, 2007

Last updated

Apr 24, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Gogebic County Community Mental Health Authority

  • Mental Health Counselor
  • Wakefield, MI
  • NPI 1912957143
  Medicare reassignment

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1851590293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W US HIGHWAY 2",
            "city": "WAKEFIELD",
            "state": "MI",
            "postal_code": "499689515",
            "telephone_number": "906-229-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W US 2",
            "address_2": "GOGEBIC COUNTY COMMUNITY MENTAL HEALTH",
            "city": "WAKEFIELD",
            "state": "MI",
            "postal_code": "499689539",
            "telephone_number": "906-229-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "TARA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-16",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "127350-121",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801089456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Lemerond, LLMSW
• Lisa Christine Leppala, RN
• Richard Jay Maher
• William Smith Malloy Jr., MSW
• Marissa Jade Massi
• Lea Miskovich, RN
• Nicole Nasi
• Jan N Neal-Cools, MD
• Robin Marie Nezworski, RN
• Laurie Ann Niemi

• Clinical Social Worker in Wakefield, MI
• Providers in Wakefield, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; 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.