Healthcare Provider Details

I. General information

NPI: 1053018598
Provider Name (Legal Business Name): ERICA MAE MILLER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8318 SMITH RD
GAINES MI
48436-9732
US

IV. Provider business mailing address

8318 SMITH RD
GAINES MI
48436-9732
US

V. Phone/Fax

Practice location:
  • Phone: 517-294-7263
  • Fax:
Mailing address:
  • Phone: 517-294-7263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6451006778
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: