DR. SAMUEL GORDON MILLER JR. (NPI# 1205034212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205034212 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL GORDON MILLER JR. |
| Credential | PSYCHOLOGIST PHD |
| Practice Address |
1190 E Broadway Louisville KY 40204 |
| Mailing Address |
1190 E Broadway Louisville KY 40204-1712 |
| Practice Telephone | 5023092408 |
| Practice Fax Number | 5027714283 |
| Mailing Telephone | 5023092408 |
| Mailing Fax Number | 5027714283 |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2018-07-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
164197 | KY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124368873 | Samuel B. Miller | Dentist | 1409 Brickyard Rd, Chipley, FL 32428-5967 | 2013-02-17 |
| 1598780637 | Samuel C Miller | Family Medicine | 3107 W Camp Wisdom Rd Ste 115, Dallas, TX 75237-2600 | 2006-07-12 |
| 1487614665 | Samuel L Miller | Orthopaedic Surgery | 2119 E South Blvd, Suite 200, Montgomery, AL 36116-2409 | 2006-03-23 |
| 1780686386 | Samuel Miller | Physical Therapist | 333 Gashes Creek Rd, Suite A, Asheville, NC 28803-9405 | 2005-08-12 |
| 1093277279 | Samuel Lowe Miller | Student in an Organized Health Care Education/Training Program | 477 Cooper Rd Ste 300, Westerville, OH 43081-8057 | 2019-04-04 |
| 1205392685 | Samuel Miller | Physical Therapy Assistant | 300 Astoria Rd, Germantown, OH 45327-1712 | 2019-02-11 |
| 1265921795 | Samuel Morrison Miller | Student in an Organized Health Care Education/Training Program | 20 York Street, Ynhh General Surgery, New Haven, CT 06510-3220 | 2018-05-10 |
| 1619407855 | Samuel J Miller | Internal Medicine | 330 Brookline Ave, Boston, MA 02215-5400 | 2017-06-19 |
| 1265973390 | Samuel Miller | Behavior Technician | 1003 7th Ave, Kirkland, WA 98033-5779 | 2017-03-08 |
| 1386063774 | Samuel Andrew Miller | Internal Medicine | 7901 Metropolis Dr, Austin, TX 78744-3111 | 2014-04-14 |
| Street Address |
1190 E BROADWAY |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629298351 | Brenda Morris | Psychologist | 1190 E Broadway, Louisville, KY 40204-1712 | 2007-04-26 |
| 1720635493 | Camala Noel Walling | Psychologist | 1190 E Broadway, Louisville, KY 40204-1712 | 2019-08-19 |
| 1912474578 | John Edward Penezic | Psychologist | 1190 E Broadway, Louisville, KY 40204-1712 | 2018-10-31 |
| 1487192977 | Tina Furness Ullrich | Psychologist | 1190 E Broadway, Louisville, KY 40204-1712 | 2017-02-06 |
| 1659829760 | Mandala House, LLC | Social Worker | 1190 E Broadway, Louisville, KY 40204-1712 | 2016-09-18 |
| 1457671232 | Adrianne Elizabeth Lange | Psychologist | 1190 E Broadway, Louisville, KY 40204-1712 | 2010-06-03 |
| 1497935324 | Christopher Colgan Tyler | Social Worker | 1190 E Broadway, Louisville, KY 40204-1712 | 2007-11-08 |
| 1124212972 | Jacquelyn M Gilles | Psychologist | 1190 E Broadway, Louisville, KY 40204-1712 | 2007-09-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619434974 | Paladina Health, LLC | Family Medicine | Paladina Health Louisville Centerstone Broadway, 914 East Broadway Suite 200, Louisville, KY 40204 | 2019-02-22 |
| 1821317975 | Abby Fowler | Social Worker | 1357 Bardstown Rd, Louisville, KY 40204 | 2010-05-27 |
| 1033317441 | Katrina Laflesh | Counselor | 914 East Broadway, 3rd Floor, Louisville, KY 40204 | 2007-07-06 |
| 1770790891 | Richard Brooks | Counselor | 914 East Broadway 1st, Louisville, KY 40204 | 2007-05-17 |
| 1447302922 | Walden Chiropractic Psc | Chiropractor | 1072 Bardstown Road, Louisville, KY 40204 | 2007-01-17 |
| 1053485938 | Hanger Prosthetics & Orthotics East Inc | Durable Medical Equipment & Medical Supplies | 1023 E Broadway, Louisville, KY 40204 | 2006-11-20 |
| 1710072137 | Sandra L. Payne | Dentist | John P Rakutt Dmd Psc, 801 Barret Avenue #107, Louisville, KY 40204 | 2006-10-03 |
| 1013017482 | Bonnie L Varisco | Social Worker | 914 E. Broadway, 2nd, Louisville, KY 40204 | 2006-09-25 |
| 1902854334 | Kevin B Spicer | Pediatrics | 834 E Broadway, Louisville, KY 40204 | 2006-05-05 |
| 1992777213 | Donna Maclain Stewart | Pathology | Office of The Chief Medical Examiner;urban Government C, 810 Barret Ave, Louisville, KY 40204 | 2006-02-02 |
| Find all providers in zip 40204 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396377164 | Mariya Leyderman | Psychologist | 974 Breckenridge Ln # 171, Louisville, KY 40207-4619 | 2020-02-10 |
| 1841821196 | Sally Losson Brenzel | Psychologist | 10503 Timberwood Cir Ste 205, Louisville, KY 40223-5395 | 2020-01-27 |
| 1013495902 | Melissa Ann Gibson | Psychologist | 6500 Glenridge Park Pl Ste 3, Louisville, KY 40222-3450 | 2018-08-01 |
| 1437645934 | Flourish Louisville | Psychologist | 6000 Brownsboro Park Blvd Ste A, Louisville, KY 40207-7201 | 2018-07-09 |
| 1982197737 | Louisville Center for Eating Disorders LLC | Psychologist | 11824 Ransum Dr # 200, Louisville, KY 40243-2802 | 2018-06-07 |
| 1801305461 | Elizabeth Swabek | Psychologist | 3703 Taylorsville Rd Ste 221, Louisville, KY 40220-1331 | 2017-09-27 |
| 1487173712 | The Wright Psychology and Learning Center, Pllc | Psychologist | 4010 Dupont Cir Ste 401, Louisville, KY 40207-4887 | 2017-09-19 |
| 1013371699 | Deshields Behavioral Wellness, Inc. | Psychologist | 2515 Gardiner Ln, Louisville, KY 40205-3003 | 2016-04-08 |
| 1851767974 | Clement Street Russell | Psychologist | 912 Lily Creek Rd, #201, Louisville, KY 40243-2815 | 2015-08-12 |
| 1306235452 | Katrina Mcbride | Psychologist | 6009 Brownsboro Park Blvd Ste C, Louisville, KY 40207-1291 | 2015-01-13 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40204 |
Please comment or provide details below to improve the information on DR. SAMUEL GORDON MILLER JR..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.