Mark James Miller, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

096398 Issued in NY

Practice address

1617 N James St Ste 200
Rome, NY 13440-2854

Phone

(315) 336-6230

Fax

(315) 337-9262

NPI assigned

Oct 17, 2018

Sex

Male

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1861968968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 N JAMES ST STE 200",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134402854",
            "telephone_number": "315-336-6230",
            "fax_number": "315-337-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 N JAMES ST STE 200",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134402854",
            "telephone_number": "315-336-6230",
            "fax_number": "315-337-9262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARK",
        "middle_name": "JAMES",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-17",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "103575-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Tan MD PC
• Maria Theresa Middleby, MS CCCA NY STATE LIC
• Allen Migliaccio, CRNA
• Christina Lyndell Miller, PA-C
• Kelly Miller
• Myron H Miller, LCSW
• Balshik Min, M.D.
• MLS Health Inc
• Malek Mohamed
• Maysarah Gamal Mohamed

• Clinical Social Worker in Rome, NY
• Providers in Rome, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.