Mauricelm-Lei Millere I, PSYCHIATRY CLINICIAN

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

261QR0405X Issued in AR

Practice address

112 Garland Ave
West Helena, AR 72390-2440

Phone

(270) 801-3436

NPI assigned

Feb 25, 2022

Last updated

Feb 25, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Psychotherapy - Behavioral & Mental Health Counseling/LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Helena, AR
  • NPI 1558017798

  Mental Health (Including Community Mental Health Center)

  NPD Authorized official

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1922754118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 GARLAND AVE",
            "city": "WEST HELENA",
            "state": "AR",
            "postal_code": "723902440",
            "telephone_number": "270-801-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 GARLAND AVE",
            "city": "WEST HELENA",
            "state": "AR",
            "postal_code": "723902440",
            "telephone_number": "270-801-3436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLERE",
        "first_name": "MAURICELM-LEI",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "PSYCHIATRY CLINICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-25",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NC",
            "license": "261QR0405X",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "AR",
            "license": "261QR0405X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OHIO CERTIFICATE / TRADE NAME REGISTRATION",
            "identifier": "201823400828",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Unysis",
            "affiliation": "N",
            "endpointDescription": "Effect of the drug, or something, on a particular",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "112 Garland Ave",
            "city": "West Helena",
            "state": "AR",
            "country_code": "US",
            "postal_code": "723902440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in West Helena, AR
• Providers in West Helena, AR by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.