Healthcare Provider Details

I. General information

NPI: 1982529699
Provider Name (Legal Business Name): JESSICA MILLER CADC-I
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 HEATHER RD
BURLINGTON NC
27215-6288
US

IV. Provider business mailing address

841 HEATHER RD
BURLINGTON NC
27215-6288
US

V. Phone/Fax

Practice location:
  • Phone: 252-541-3833
  • Fax:
Mailing address:
  • Phone: 252-541-3833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCADC-32446
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: