Individual provider Active NPI

Nicole Michele Hoffman Miller, PSY.D.

  • Psychologist
  • Cleveland, TN
National Provider Identifier
1962608588
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4123 Issued in TN
Practice address
2700 Executive Park NW Ste a
Cleveland, TN 37312-2770
Phone
(540) 418-0105
Fax
(540) 404-2126
NPI assigned
Jun 21, 2007
Last updated
Oct 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6040 NC
Psychologist 103T00000X 4123 TN Primary
Psychologist 103T00000X 0810004434 VA
Clinical Child & Adolescent Psychologist 103TC2200X 0810004434 VA
Clinical Child & Adolescent Psychologist 103TC2200X 4123 TN
Family Psychologist 103TF0000X 4123 TN
Family Psychologist 103TF0000X 0810004434 VA

Addresses

Primary practice location

2700 Executive Park NW Ste a
Cleveland, TN 37312-2770

Mailing address

3139 Brookmore TRL NW
Cleveland, TN 37312-2421
Phone (540) 759-0037

Other identifiers 1

IdentifierTypeStateIssuer
1962608588MedicaidVA

Other names 1

  • Dr. Nicole Michele Hoffman Miller Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0810004434VAMDFamily Psychologist
6040NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Psychological Services, PLLC Psychologist CurrentSince Aug 28, 2022 Accepting new patients
Nicole Hoffman Miller PSYD LLC Current Accepting new patients

Locations

3697 East Wilson St
Farmville, NC 27828

2700 Executive Park NW
Ste A
Cleveland, TN 37312
Phone (423) 436-1565

606 S Market St
Salem, VA 24153
Phone (423) 967-9951

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1962608588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3139 BROOKMORE TRL NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373122421",
            "telephone_number": "540-759-0037",
            "fax_number": "540-404-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 EXECUTIVE PARK NW STE A",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373122770",
            "telephone_number": "540-418-0105",
            "fax_number": "540-404-2126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN MILLER",
        "first_name": "NICOLE",
        "middle_name": "MICHELE",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "6040",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "4123",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810004434",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "VA",
            "license": "0810004434",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "TN",
            "license": "4123",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "TN",
            "license": "4123",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "VA",
            "license": "0810004434",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962608588",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "HOFFMAN MILLER",
            "middle_name": "MICHELE",
            "prefix": "DR.",
            "credential": "PSYD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; 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.