Individual provider Active NPI

Nan Miller, LCSW, PH.D.

  • Clinical Social Worker
  • Mount Kisco, NY
National Provider Identifier
1881624740
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PR003358-1 Issued in NY
Practice address
275 E Main St
Mount Kisco, NY 10549-3030
Phone
(914) 273-3251
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X PR003358-1 NY Primary

Addresses

Primary practice location

275 E Main St
Mount Kisco, NY 10549-3030

Mailing address

275 E Main St
Mount Kisco, NY 10549-3030
Phone (914) 273-3251

Other identifiers 2

IdentifierTypeStateIssuer
0004242219OtherNYAETNA PIN
0073121OtherNYGHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20061025000804 NY Practitioner - Clinical Social Worker 0840297362 Practice locations: White Plains, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
New York University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

100 Maple Ave
White Plains, NY 10601-5105
Phone (914) 390-0080

4 Green Valley Rd
Armonk, NY 10504-2415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PR003358-1NYMDClinical Social Worker
003358NYMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881624740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 E MAIN ST",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493030",
            "telephone_number": "914-273-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 E MAIN ST",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493030",
            "telephone_number": "914-273-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "NAN",
        "name_prefix": "Dr.",
        "credential": "LCSW, PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR003358-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "0004242219",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0073121",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

Verify at the official NPI Registry.