JACKIE L MILLER (NPI# 1922549567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922549567 |
| Entity Type | Individual |
| Full Name | JACKIE L MILLER |
| Credential | LPC |
| Practice Address |
1517 E Huebbe Pkwy Ste A Beloit WI 53511-1795 |
| Practice Telephone | 6082915891 |
| Practice Fax Number | 6087139040 |
| Mailing Telephone | 6082915891 |
| Mailing Fax Number | 6087139040 |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2020-04-09 |
| NPI Deactivation Date | 02/14/2019 |
| NPI Reactivation Date | 2019-02-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
7632-125 | WI | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
7632-125 | WI | Behavioral Health & Social Service Providers |
| N | 376K00000X | Nurse's Aide | NA131596 | WI | Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100086806 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861001117 | Jackie Charlene Miller | Psychologist | 1910 37th Ave, Phenix City, AL 36870-3528 | 2020-07-23 |
| 1003875311 | Jackie L Miller | Hearing Instrument Specialist | 4110 Brainerd Rd, Chattanooga, TN 37411-3700 | 2006-03-23 |
| 1316396492 | Jackie S Miller | Pharmacist | 1340 Ridgewood Ave, Holly Hill, FL 32117-2320 | 2016-06-08 |
| 1235542770 | Jackie Elaine Miller | Registered Nurse | 1880 Canton Rd, Akron, OH 44312-4074 | 2014-06-03 |
| 1770679664 | Jackie May Miller | Counselor | 650 S Peoria Ave, Tulsa, OK 74120-4429 | 2006-10-05 |
| 1053353045 | Jackie S Miller | Family Medicine | 1607 E Us Highway 136, Albany, MO 64402-8223 | 2006-06-12 |
| 1205899507 | Jackie Robinson Miller | Family Medicine | 701 W Plymouth Ave, Deland, FL 32720-3236 | 2006-04-08 |
| Street Address |
1517 E HUEBBE PKWY STE A |
| City | BELOIT |
| State | WI |
| Zip Code | 53511-1795 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770047839 | Heather Heritage | Social Worker | 1517 E Huebbe Pkwy Ste A, Beloit, WI 53511-1795 | 2019-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730738485 | Linda Lee Cook | Technician | 914 Cranston Rd., Beloit, WI 53511 | 2019-09-05 |
| 1033773734 | Holistic Counseling Services, LLC | Counselor | 1517 Huebbe Parkway, Ste A, Beloit, WI 53511 | 2019-04-28 |
| 1578073870 | Bonita May Cooke | Counselor | 838 Grant St., Beloit, WI 53511 | 2017-10-02 |
| 1679091219 | Stacy Lynn Gallagher | Licensed Practical Nurse | 1060 Bittel St, Beloit, WI 53511 | 2017-09-04 |
| 1629448824 | Brenda Jean Allen | Registered Nurse | 2907 E. Leona Drive, Beloit, WI 53511 | 2015-09-30 |
| 1033595038 | Amber Noel Slaybaugh | Physical Therapist | 838 E. Azalea Ter., Beloit, WI 53511 | 2015-08-03 |
| 1407260326 | Quirt Family Dentistry, Sc | Dentist | 2777 Milwaukee Rd, Beloit, WI 53511 | 2014-06-18 |
| 1821436973 | Raymond K Spade | Counselor | 2240 Prairie Ave., Beloit, WI 53511 | 2013-06-11 |
| 1629321658 | Sarah Ann Nelson | Physical Therapist | 1905 W. Hart Road, Beloit, WI 53511 | 2012-10-15 |
| 1235494212 | Mary Ann Hudson | Nurse Practitioner | 700 College Street, Beloit College, Beloit, WI 53511 | 2012-07-06 |
| Find all providers in zip 53511 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396303871 | Marilyn Lensert Harris | Counselor | 1827 Chippewa Trl, Beloit, WI 53511-3817 | 2019-05-30 |
| 1639610520 | Dana M Ellis | Counselor | 136 W Grand Ave, Beloit, WI 53511-6259 | 2017-03-13 |
| 1043481385 | Rhonda S Doherty | Counselor | 64 Eclipse Cetner, Beloit, WI 53511 | 2008-03-14 |
| 1073794467 | Heidi L Lammon | Counselor | 3005 S Riverside Dr, Suite 102, Beloit, WI 53511-1500 | 2007-11-14 |
| 1811177991 | Stephanie Knueppel | Counselor | 400 E Grand Ave Ste 308, Beloit, WI 53511-6200 | 2007-11-06 |
| 1578041919 | Michael Blaine Johnson | Counselor | 416 College St, Beloit, WI 53511-6310 | 2018-07-28 |
| 1972099505 | Melissa L Beckford | Counselor | 136 W Grand Ave Ste 250, Beloit, WI 53511-6273 | 2018-07-06 |
| 1740704287 | Melony Dawn Walsh | Counselor | 540 E Grand Ave, Beloit, WI 53511-6314 | 2017-07-26 |
| 1821510595 | Jenniffer Beu | Counselor | 540 E Grand Ave, Beloit, WI 53511-6314 | 2017-07-13 |
| 1245761535 | Ashley L Robinson | Counselor | 136 W Grand Ave, Suite 250, Beloit, WI 53511-6259 | 2017-03-27 |
| Find all providers in BELOIT | ||||
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| 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.