KYLE WILLIAM MILLER LCSW
NPI 1629744917
Social Worker - Clinical in Eldorado, IL

Active since August 18, 2021Opted out of Medicare · through Mar 4, 2028
1200 LOCUST ST, ELDORADO, IL 62930(618) 697-8005 Get Directions Write a Review

NPPES record last updated: August 18, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Kyle William Miller Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KYLE WILLIAM MILLER LCSW (NPI 1629744917) is an individual clinical provider in Eldorado, Illinois and active in the NPI registry since August 2021. He has opted out of Medicare through March 4, 2028 and maintains a secondary practice location in Murphysboro.

NPPES Registry Identity

NPI1629744917
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameKYLE WILLIAM MILLERCredential: LCSW
Location Address1200 LOCUST STEldorado, IL 62930-1723
Mailing Address1200 Locust StEldorado, IL 62930-1723 · (618) 687-8005
Sole ProprietorNo
Enumeration DateAugust 18, 2021
NPPES CertifiedAugust 11, 2021
NPI 1629744917 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

1200 LOCUST ST, Eldorado, IL 62930

Secondary Practice Location 1

Location 11400 N Wood RdMurphysboro, IL 62966-6290 · Phone (618) 687-8005

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Kyle William Miller Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 4, 2024 through March 4, 2028.

Opt-Out Effective DateMarch 4, 2024
Opt-Out In Effect ThroughMarch 4, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (School)
1200 LOCUST ST
ELDORADO, IL 62930
Psychologist (School)
1200 LOCUST ST
ELDORADO, IL 62930
Social Worker (Clinical)
1200 LOCUST ST
ELDORADO, IL 62930
Psychologist (Clinical Child & Adolescent)
1200 LOCUST ST
ELDORADO, IL 62930
Clinic/Center (Adolescent and Children Mental Health)
1200 LOCUST ST
ELDORADO, IL 62930
Counselor
1200 LOCUST ST
ELDORADO, IL 62930
Counselor
1200 LOCUST ST
ELDORADO, IL 62930
Counselor
1200 LOCUST ST
ELDORADO, IL 62930

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kyle Miller's NPI number?

The NPI number for Kyle Miller is 1629744917. It was assigned to this individual provider in the NPPES registry on August 18, 2021.

Where is Kyle Miller located?

Kyle Miller practices at 1200 Locust St, Eldorado, IL 62930. The listed phone number is (618) 697-8005.

What is Kyle Miller's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kyle Miller enrolled in Medicare?

No. Kyle Miller has opted out of Medicare through March 4, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Kyle Miller was last updated on August 18, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.