Healthcare Provider Details

I. General information

NPI: 1073384087
Provider Name (Legal Business Name): CONNIE BLEUE MILLER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 GARDEN OF THE GODS RD
COLORADO SPRINGS CO
80907-3419
US

IV. Provider business mailing address

1365 GARDEN OF THE GODS RD
COLORADO SPRINGS CO
80907-3419
US

V. Phone/Fax

Practice location:
  • Phone: 719-726-4534
  • Fax:
Mailing address:
  • Phone: 719-726-4534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09933030
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: