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NPI Code Detail

MEDICARE: LUCY ANNE MILLER

MEDICARE: LUCY ANNE MILLER
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
1101YM0800XMental Health CounselorLCPC-7625ID

General Provider Information

NPI Number : 1902251754
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCY ANNE MILLER
Provider Business Mailing Address
First Line : 1065 E WINDING CREEK DR STE 250
Second Line :
City : EAGLE
State : ID
Zip : 83616-7246
Country : US
Telephone Number : 208-505-9588
Fax Number :
Provider Business Practice Location Address
First Line : 1065 E WINDING CREEK DR STE 250
Second Line :
City : EAGLE
State : ID
Zip : 83616-7246
Country : US
Telephone Number : 208-505-9588
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2016
Last Update Date : 12/28/2025

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Directions to “ LUCY ANNE MILLER ” Practice Location

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