Healthcare Provider Details

I. General information

NPI: 1609041037
Provider Name (Legal Business Name): SONIA MARIA MILLER CSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2008
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E BROADWAY STE 300
EUGENE OR
97401-3114
US

IV. Provider business mailing address

2322 CLEVELAND ST
EUGENE OR
97405-1648
US

V. Phone/Fax

Practice location:
  • Phone: 541-357-9764
  • Fax:
Mailing address:
  • Phone: 503-949-9707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA16109
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: