=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699682963
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOBY M MILLER MSW, LSW, RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/25/2026
-----------------------------------------------------
Last Update Date | 08/25/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1450 N COUNTY ROAD 2050 E
-----------------------------------------------------
City | CARTHAGE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 62321-3551
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 217-357-6888
-----------------------------------------------------
Fax | 217-357-6889
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 HICKORY GRV
-----------------------------------------------------
City | MACOMB
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61455-1108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 217-357-6888
-----------------------------------------------------
Fax | 217-357-6889
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 041.378720
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 150.131206
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------