Healthcare Provider Details

I. General information

NPI: 1053233304
Provider Name (Legal Business Name): WILSON MILLER COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1347 W MAIN ST
DOTHAN AL
36301-1309
US

IV. Provider business mailing address

114 ORCHARD PARK DR
DOTHAN AL
36301-1113
US

V. Phone/Fax

Practice location:
  • Phone: 334-790-4370
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JORDAN MILLER
Title or Position: OWNER
Credential: LPC
Phone: 334-790-4370