Individual provider Active NPI

Eva Miller, PHD

  • Rehabilitation Psychologist
  • Las Vegas, NV
National Provider Identifier
1982755799
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PsychologistTaxonomy code 103TR0400X
License
PY0772 Issued in NV
Practice address
3651 Lindell Rd
Ste D396
Las Vegas, NV 89103-1254
Phone
(956) 994-3880
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Psychologist 103TR0400X PY0772 NV Primary

Addresses

Primary practice location

3651 Lindell Rd
Ste D396
Las Vegas, NV 89103-1254

Mailing address

3651 Lindell Rd
Ste D396
Las Vegas, NV 89103-1254
Phone (956) 207-1725

Other identifiers 1

IdentifierTypeStateIssuer
1473233-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170911003018 NV Practitioner - Clinical Psychologist 8921043852 Reassigns benefits to 1 organization
I20210519001317 AZ Practitioner - Clinical Psychologist 8921043852 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY0772NVMDRehabilitation Psychologist
31545TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Psychological Services Current Accepting new patients
Sondermind Provider Network LLC CurrentSince Feb 4, 2021 Accepting new patients
Cognitive Care Solutions Group Inc CurrentSince Sep 15, 2019 Accepting new patients
Deer Oaks Geriatric Services P C PastSince Jan 23, 2023 Accepting new patients
Deer Oaks Mental Health Associates PC Past Accepting new patients

Locations

20 E Thomas Rd
Ste 2200
Phoenix, AZ 85012
Phone (310) 515-8113

3943 Irvine Blvd
Irvine, CA 92602
Phone (714) 922-0120

2320 Ione Rd
Las Vegas, NV 89183
Phone (725) 200-3400

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1982755799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 LINDELL RD",
            "address_2": "STE D396",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891031254",
            "telephone_number": "956-207-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 LINDELL RD",
            "address_2": "STE D396",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891031254",
            "telephone_number": "956-994-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "EVA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "NV",
            "license": "PY0772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1473233-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.