Healthcare Provider Details

I. General information

NPI: 1265213052
Provider Name (Legal Business Name): CATHEREN MILLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2023
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 STANTON L YOUNG BLVD STE 520
OKLAHOMA CITY OK
73104-5022
US

IV. Provider business mailing address

6051 N BROOKLINE AVE STE 112
OKLAHOMA CITY OK
73112-4286
US

V. Phone/Fax

Practice location:
  • Phone: 405-213-9811
  • Fax:
Mailing address:
  • Phone: 405-213-9811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number21510
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: