Annelise Nystrom Miller

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

3468 Mt Diablo Blvd Ste B201
Lafayette, CA 94549-3959

Phone

(925) 284-2298

NPI assigned

May 18, 2020

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Marriage and Family Therapist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1871116400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3468 MT DIABLO BLVD STE B201",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945493959",
            "telephone_number": "925-255-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3468 MT DIABLO BLVD STE B201",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945493959",
            "telephone_number": "925-284-2298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ANNELISE",
        "middle_name": "NYSTROM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-18",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Michaels, PH.D.
• Mary Roy Michaels, MFT
• Patricia Mickens, MFT
• Mary Lou Mied, PH.D.
• Maya Millar
• Aubrey Miller
• Stefan Mitosinka
• Modesto Radiological Medical Group
• Calley Moita
• Herbert Robert Monroe, O.D.

• Mental Health Counselor in Lafayette, CA
• Providers in Lafayette, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.