Healthcare Provider Details

I. General information

NPI: 1598388639
Provider Name (Legal Business Name): MILLER & ASSOCIATES CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2020
Last Update Date: 05/23/2020
Certification Date: 05/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 S MILL AVE STE 203
TEMPE AZ
85282-7734
US

IV. Provider business mailing address

4820 S MILL AVE STE 203
TEMPE AZ
85282-7734
US

V. Phone/Fax

Practice location:
  • Phone: 480-600-0539
  • Fax:
Mailing address:
  • Phone: 480-600-0539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIMBERLY MILLER
Title or Position: OWNER
Credential: LCSW
Phone: 480-600-0539