Healthcare Provider Details

I. General information

NPI: 1659025583
Provider Name (Legal Business Name): LEANNE MILLER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 CELEBRATION BLVD STE 405
CELEBRATION FL
34747-5165
US

IV. Provider business mailing address

2551 SANDERLING ST
HAINES CITY FL
33844-8437
US

V. Phone/Fax

Practice location:
  • Phone: 321-559-7015
  • Fax: 321-233-9959
Mailing address:
  • Phone: 267-306-7969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH19941
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH22160
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: