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Deactivated NPI 1689767386 Deactivated / Inactive NPI Male Practitioner

Dr. John Gilbert Miller , PhD

Psychologist • Springfield, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. John Miller has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 02, 2006
NPI Deactivation Date December 26, 2024
Total Practice Duration ~18 Years of Practice (2006 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. John Miller, PhD was a registered Psychologist practicing in Springfield, IL. Throughout an active medical career spanning 18 years, Dr. Miller provided care at the practice location at 1124 S 5TH ST until profile deactivation on 2024-12-26.

Practice Location & Contact Primary Location

Practice Address

1124 S 5th St

Springfield, IL 627032314

Telephone 2177443525
Fax 2177443535
Associated Practice Facility / Clinic
🏢 Gene A Brodland Lcsw, Llc Facility NPI 1528466430

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Springfield, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 39.0 Yrs
State Avg: 25.1 Yrs
Regional Practice Density
8 Specialists

Practicing in Springfield, IL (1075 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License IL 071.001736

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

17 Associated Practitioners
Jami Jamieson , LCSW

Social Worker - Clinical

NPI 1003274952

Licensed Clinical Social Worker

Mary Ray , LPC

Counselor - Mental Health

NPI 1033652573

Licensed Professional Counselor

Debra Blumthal , NCC, LCPC

Counselor - Professional

NPI 1063541308

National Certified Counselor, Licensed Clinical Professional Counselor

Donald Henke , LCSW

Social Worker - Clinical

NPI 1083740211

Licensed Clinical Social Worker

Kelly Dial , LCSW

Social Worker - Clinical

NPI 1225120819

Licensed Clinical Social Worker

Brian Burris , LCPC

Counselor - Professional

NPI 1255410130

Licensed Clinical Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
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NPI Profile Deactivated December 26, 2024

Record deactivated on December 26, 2024

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Updated Practice Location February 27, 2018

Registered at 215 S GRAND AVE W, SPRINGFIELD, IL 627043885 (Tel: 2177443525)

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Updated Business Mailing Address February 27, 2018

Registered at 215 S GRAND AVE W, SPRINGFIELD, IL 627043885 (Tel: 2177443525)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 1124 S 5TH ST, SPRINGFIELD, IL 627032314 (Tel: 2177443525)

📍
Updated Business Mailing Address July 08, 2007

Registered at 1124 S 5TH ST, SPRINGFIELD, IL 627032314 (Tel: 2177443525)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JOHN MILLER, PHD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Psychologist (License #071.001736 in IL)

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Initial NPI Registration & Enumeration October 02, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1689767386
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 02, 2006
Last Update: July 08, 2007
Deactivation Date: December 26, 2024

Mailing Address

1124 S 5th St

Springfield, IL 627032314

Phone: 2177443525

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.