Kellie L Miller, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC12095 Issued in ME

Practice address

2 Armco Ave
Caribou, ME 04736-1602

Phone

(207) 493-1700

Fax

(207) 493-1702

NPI assigned

Jun 26, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

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

Clinical Social Worker

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SweetserGroup PAC ID 8325946213, 138 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelliemiller@tdh.allscriptsdirect.net

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.

• Sweetser

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saco, ME
  • NPI 1538122445
  Medicare reassignment Care Compare group NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD
• Androscoggin Home Health Services, Inc.

  • Developmental Therapist
  • Lewiston, ME
  • NPI 1962646844
  NPD (past)

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552176000000",
    "number": "1932305802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 313",
            "city": "CARIBOU",
            "state": "ME",
            "postal_code": "047360313",
            "telephone_number": "207-493-1700",
            "fax_number": "207-493-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ARMCO AVE",
            "city": "CARIBOU",
            "state": "ME",
            "postal_code": "047361602",
            "telephone_number": "207-493-1700",
            "fax_number": "207-493-1702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "165 Academy St",
            "address_purpose": "LOCATION",
            "city": "Presque Isle",
            "state": "ME",
            "postal_code": "047693170",
            "country_code": "US",
            "telephone_number": "207-764-3071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KELLIE",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2019-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC12095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432600099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vanessa Elizabeth McDougall, FNP
• Megan McKnight, OQMHP-C
• Merriann Merriman, MHRT-CSP
• Jean Pierre Michaud, MD
• Michael Michaud
• Annette Moffet, OQMHP-C
• Tania M. Morey, MHRT-C
• Keren Morin, OQMHP-COMMUNITY
• Susan Carrigan Morrill
• Edwina Louise Morris

• Clinical Social Worker in Caribou, ME
• Providers in Caribou, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2019; 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.