Jennifer Fae Miller, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34009407A Issued in IN

Practice address

Calumet High School
3900 Calhoun St., Door R
Gary, IN 46408

Phone

(219) 240-1851

NPI assigned

Sep 15, 2021

Last updated

Sep 15, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Porter-Starke Services Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Valparaiso, IN
  • NPI 1689627598
  Medicare reassignment
• Community Healthnet Inc

  dba Morton High School

  • Federally Qualified Health Center (FQHC)
  • Hammond, IN
  • NPI 1164161469
  NPD (past)
• Community Healthnet Inc

  • Federally Qualified Health Center (FQHC)
  • Gary, IN
  • NPI 1649539933
  NPD (past)
• Community Healthnet Inc

  dba Community HealthNet@MLK

  • Federally Qualified Health Center (FQHC)
  • Gary, IN
  • NPI 1891262762
  NPD (past)
• Community Healthnet Inc

  • Federally Qualified Health Center (FQHC)
  • Merrillville, IN
  • NPI 1952660243
  NPD (past)

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1962172627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6914 OLD PORTER CT APT 1",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463681779",
            "telephone_number": "219-331-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALUMET HIGH SCHOOL",
            "address_2": "3900 CALHOUN ST., DOOR R",
            "city": "GARY",
            "state": "IN",
            "postal_code": "46408",
            "telephone_number": "219-240-1851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1021 W 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Gary",
            "state": "IN",
            "postal_code": "464021703",
            "country_code": "US",
            "telephone_number": "219-240-1851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JENNIFER",
        "middle_name": "FAE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009407A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imran Muhammad Mihas
• Tajane Miles
• Derrick Earnest Millard
• Millennium Ultrasound LLC
• Miller Drug Co Inc.
• Marion Bernice Miller, RN
• Trevor Miller, MA CCC-SLP
• Mind Empowerment LLC
• Evan Minger, PA-C
• Mobile Medical Transport, Incorporated

• Clinical Social Worker in Gary, IN
• Providers in Gary, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.