Healthcare Provider Details

I. General information

NPI: 1912030461
Provider Name (Legal Business Name): CYNTHIA LOUISE MILLER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 E BAGLEY RD
BEREA OH
44017-2038
US

IV. Provider business mailing address

2260 STATE ST NW
UNIONTOWN OH
44685-7610
US

V. Phone/Fax

Practice location:
  • Phone: 440-260-8314
  • Fax: 440-260-8388
Mailing address:
  • Phone: 330-494-8646
  • Fax: 330-494-8646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE0001616
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: