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1083229264 NPI number — ALEXA RAE MILLER MSW

NPI Number: 1083229264
Health Care Provider/Practitioner: ALEXA RAE MILLER MSW

Information about “1083229264” NPI (ALEXA RAE MILLER MSW) exists in 1083229264 in HTML format HTML  |  1083229264 in plain Text format TXT  |  1083229264 in PDF (Portable Document Format) PDF  |  1083229264 in an XML format XML  formats.

NPI Number : 1083229264 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1083229264",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MILLER",
    "FirstName": "ALEXA",
    "MiddleName": "RAE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6250 TELEGRAPH RD APT 1408",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "VENTURA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "93003-4346",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2202 S CEDAR ST STE 175",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TACOMA",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98405-2310",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "317-937-4542",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/14/2020",
    "LastUpdateDate": "01/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": "01/27/2023",
    "NPIReactivationDate": "03/07/2023",
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "61619369",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "106S00000X",
          "TaxonomyName": "Behavior Technician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "171M00000X",
          "TaxonomyName": "Case Manager/Care Coordinator",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "172V00000X",
          "TaxonomyName": "Community Health Worker",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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