Kimberly Miller, LCSW, SAC-IT is a
Social Worker - Clinical based in Jefferson, Wisconsin. Kimberly Miller is licensed to practice in Wisconsin (license number 9598-123) and her current practice location is
1541 Annex Rd, Jefferson, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(920) 674-3105.
NPI number for Kimberly Miller is 1144786658 and her current mailing address is N114 West St Apt 6, Waterloo, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1144786658.
Healthcare Provider's Profile
| Full Name | Kimberly Miller |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 1541 Annex Rd, Jefferson, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1144786658
- Provider Enumeration Date: 02/20/2019
- Last Update Date: 01/26/2021
Medical Identifiers
Medical identifiers for Kimberly Miller such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1144786658 | NPI | - | NPPES |
| 42138100 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 18467-130 (Wisconsin) | Secondary |
| 104100000X | Social Worker | 131240-121 (Wisconsin) | Secondary |
| 1041C0700X | Social Worker - Clinical | 9598-123 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberly Miller is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kimberly Miller, LCSW, SAC-IT
N114 West St Apt 6,
Waterloo, WI 53594-9214
Ph: (920) 904-0770 | Kimberly Miller, LCSW, SAC-IT
1541 Annex Rd,
Jefferson, WI 53549-9803
Ph: (920) 674-3105 |
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