Roselynn E Miller, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY003394 Issued in GA

Practice address

1112 Warrenhall LN NE
Brookhaven, GA 30319-1938

Phone

(404) 919-7721

NPI assigned

Mar 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 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1952429235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 WARRENHALL LN NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303191938",
            "telephone_number": "404-594-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 WARRENHALL LN NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303191938",
            "telephone_number": "404-919-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ROSELYNN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "1591",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "725279494B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121175",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ania Miles, RBT
• Candice Miller, RBT
• Chasity Miller, RBT
• Clay Miller
• Reyana Miller, RBT
• Shameyrae Devonya Miller
• Miracle Kids LLC
• Joanna M Miranda, OD
• Brittany Nicole Mitchell, RBT
• Hassan Marwan Mohammed Salih, DDS

• Clinical Psychologist in Brookhaven, GA
• Providers in Brookhaven, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.