MEDICARE: CAROLYN MILLER LCSW

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	1041C0700X	Clinical Social Worker	CW012698	PA

General Provider Information

NPI Number	:	1225051709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN MILLER LCSW

Provider Business Mailing Address
First Line	:	1425 HORSHAM RD
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-1320
Country	:	US
Telephone Number	:	215-371-1347
Fax Number	:	215-371-3030

Provider Business Practice Location Address
First Line	:	1425 HORSHAM RD
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-1320
Country	:	US
Telephone Number	:	215-371-1347
Fax Number	:	215-371-3030

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	02/14/2014

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