Individual provider Active NPI

Courtenay Ann Miller, LCSW

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1922644053
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1373 Issued in KY
Practice address
8704 Dorrance Dr
Louisville, KY 40258-1016
Phone
(502) 333-8471
NPI assigned
Nov 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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 1373 KY Primary

Addresses

Primary practice location

8704 Dorrance Dr
Louisville, KY 40258-1016

Mailing address

8704 Dorrance Dr
Louisville, KY 40258-1016
Phone (502) 333-8471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191230002233 KY Practitioner - Clinical Social Worker 2365876208 Reassigns benefits to 2 organizations
I20211129000335 IN Practitioner - Clinical Social Worker 2365876208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Extended Care Specialists, IncGroup PAC ID 2466407713, 295 clinicians

Practice addresses (Care Compare)

828 Lane Allen Rd
Suite 219
Lexington, KY 40504-3659
Phone (260) 483-9081

8398 Mississippi St
FL 2
Merrillville, IN 46410-6316
Phone (855) 743-2247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1373KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Extended Care Specialists, Inc Clinical CurrentSince Nov 1, 2021 Accepting new patients
Eventus Wholehealth Midwest Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

3512 Stellhorn Rd
Fort Wayne, IN 46815

8398 Mississippi St
Fl 2
Merrillville, IN 46410

828 Lane Allen Rd
Ste 219
Lexington, KY 40504

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1922644053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8704 DORRANCE DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402581016",
            "telephone_number": "502-333-8471",
            "fax_number": "502-365-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8704 DORRANCE DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402581016",
            "telephone_number": "502-333-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "COURTENAY",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "1373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.