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Deactivated NPI 1922549567 Deactivated / Inactive NPI Female Practitioner

Jackie L Miller , LPC

Counselor - Professional • Beloit, WI

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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, Jackie Miller has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 15, 2017
NPI Deactivation Date February 14, 2019
Total Practice Duration ~2 Years of Practice (2017 – 2019)

Professional Overview & Biography Verified Profile Summary

Jackie Miller, LPC was a registered Counselor - Professional practicing in Beloit, WI. Throughout an active medical career spanning 2 years, Jackie Miller provided care at the practice location at 1517 E HUEBBE PKWY STE A until profile deactivation on 2019-02-14.

Practice Location & Contact Primary Location

Practice Address

1517 E Huebbe Pkwy Ste A

Beloit, WI 535111795

Telephone 6082915891
Fax 6087139040
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Beloit, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.6 Yrs
State Avg: 12.8 Yrs
Regional Practice Density
43 Specialists

Practicing in Beloit, WI (4511 Statewide)

Telehealth Adoption Rate
7.0% 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

CMS Verified: 2020-04-09
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License WI 7632-125

Definition to come...

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

State License WI 7632-125

Definition to come...

Nurse's Aide

NUCC Taxonomy Code: 376K00000X

State License WI NA131596

(1) An unlicensed individual who is trained to function in an assistive role to the licensed nurse in the provision of patient/client activities as delegated by the nurse; (2) An individual trained (either on-the-job or through a formal course generally of less than one year) and experienced in performing patient or client-care nursing tasks that do not require the skills of a specialist, technician, or professional. Examples of tasks performed by nurses aides include changing clothes, diapers, and beds; assisting patients to perform exercises or personal hygiene tasks, and supporting communication or social interaction. Specific education and credentials are not required for this work.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
100086806 (WI)

Practice Associates & Co-Workers

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

2 Associated Practitioners
Haven Mcclure , APSW

Counselor - Mental Health

NPI 1043881998
Alex Troupis , APSW

Social Worker - Clinical

NPI 1265174668

Career & Practice History Timeline

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

16 Historical Events
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Updated Practice Location April 09, 2020

Registered at 1517 E HUEBBE PKWY STE A, BELOIT, WI 535111795 (Tel: 6082915891)

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Updated Business Mailing Address April 09, 2020

Registered at 1517 E HUEBBE PKWY STE A, BELOIT, WI 535111795 (Tel: 6082915891)

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Provider Name / Credentials Updated January 01, 2020

Recorded as JACKIE MILLER, LPC

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 01, 2020

Counselor (License #7632-125 in WI)

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Updated Practice Location March 02, 2019

Registered at 816 4TH ST STE 203, BELOIT, WI 535114431 (Tel: 6082915891)

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Updated Business Mailing Address March 02, 2019

Registered at 816 4TH ST STE 203, BELOIT, WI 535114431 (Tel: 6082915891)

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Provider Name / Credentials Updated March 02, 2019

Recorded as JACKIE MILLER, LPC-IT

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 02, 2019

Counselor (License #3482-226 in WI)

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NPI Profile Reactivated February 22, 2019

Record officially reactivated for active practice on February 22, 2019

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NPI Profile Deactivated February 14, 2019

Record deactivated on February 14, 2019

NPI Profile Active March 15, 2017

NPI status registered as active in NPPES database

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Updated Practice Location March 15, 2017

Registered at 136 W GRAND AVE STE 250, BELOIT, WI 535116273 (Tel: 6083468315)

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Updated Business Mailing Address March 15, 2017

Registered at 1213 MERRILL AVE, BELOIT, WI 535115029 (Tel: 6082079401)

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Provider Name / Credentials Updated March 15, 2017

Recorded as JACKIE MILLER

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 15, 2017

Counselor

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Initial NPI Registration & Enumeration March 15, 2017

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: 1922549567
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 15, 2017
Last Update: April 09, 2020
Deactivation Date: February 14, 2019
Sole Proprietor: Yes

Mailing Address

1517 E Huebbe Pkwy Ste A

Beloit, WI 535111795

Phone: 6082915891

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.