Healthcare Provider Details

I. General information

NPI: 1952689218
Provider Name (Legal Business Name): MICHAEL F. MILLER LPCMH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2011
Last Update Date: 08/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 E LOOCKERMAN ST SUITE 213
DOVER DE
19901-8306
US

IV. Provider business mailing address

9 E LOOCKERMAN ST SUITE 213
DOVER DE
19901-8306
US

V. Phone/Fax

Practice location:
  • Phone: 302-677-1758
  • Fax:
Mailing address:
  • Phone: 302-677-1758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC0000556
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC0000556
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: