Individual provider Active NPI

Judy D Miller, EDS

  • Psychologist
  • Cookeville, TN
National Provider Identifier
1891830600
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1708 Issued in TN
Practice address
34 N Jefferson Ave Ste a
Cookeville, TN 38501-3392
Phone
(931) 528-2371
Fax
(931) 582-2376
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1708 TN
Psychologist 103T00000X 1708 TN Primary

Addresses

Primary practice location

34 N Jefferson Ave Ste a
Cookeville, TN 38501-3392

Mailing address

34 N Jefferson Ave Ste a
Cookeville, TN 38501-3392
Phone (931) 528-2371

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

State licenses

LicenseStateTypeSpecialty
1708TNMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1891830600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 N JEFFERSON AVE STE A",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013392",
            "telephone_number": "931-528-2371",
            "fax_number": "931-582-2376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 N JEFFERSON AVE STE A",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013392",
            "telephone_number": "931-528-2371",
            "fax_number": "931-582-2376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JUDY",
        "middle_name": "D",
        "credential": "EDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "1708",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "1708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.