Healthcare Provider Details

I. General information

NPI: 1376868653
Provider Name (Legal Business Name): BARBARA MILLER LCMHCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2010
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 TURNERSBURG HWY
STATESVILLE NC
28625-2798
US

IV. Provider business mailing address

284 EXECUTIVE PARK DR STE 100
CONCORD NC
28025-1831
US

V. Phone/Fax

Practice location:
  • Phone: 704-873-1114
  • Fax: 704-873-9917
Mailing address:
  • Phone: 704-939-1100
  • Fax: 704-939-1173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberQS134644
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7868
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: