MEDICARE: JAIDAN MARIE MILLER APSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	135510	WI
2	1041C0700X	Clinical Social Worker	135510121	WI

General Provider Information

NPI Number	:	1780578609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIDAN MARIE MILLER APSW

Provider Business Mailing Address
First Line	:	3 NEENAH CTR
Second Line	:
City	:	NEENAH
State	:	WI
Zip	:	54956-3070
Country	:	US
Telephone Number	:	920-830-5900
Fax Number	:	920-830-5910

Provider Business Practice Location Address
First Line	:	710 PARK AVE
Second Line	:
City	:	WAUPACA
State	:	WI
Zip	:	54981-1956
Country	:	US
Telephone Number	:	920-720-2300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2025
Last Update Date	:	06/02/2026

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Directions to “ JAIDAN MARIE MILLER APSW” Practice Location

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