Healthcare Provider Details

I. General information

NPI: 1023116555
Provider Name (Legal Business Name): JOHN F MILLER LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 11/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4413 CORUNNA RD DELTA FAMILY CLINIC
FLINT MI
48532
US

IV. Provider business mailing address

4413 CORUNNA RD
FLINT MI
48532
US

V. Phone/Fax

Practice location:
  • Phone: 810-630-1152
  • Fax: 810-630-9107
Mailing address:
  • Phone: 810-630-1152
  • Fax: 810-630-9107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801015687
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801015687
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801015687
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: