Healthcare Provider Details

I. General information

NPI: 1285223669
Provider Name (Legal Business Name): KRISTIN MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTIN MILLER

II. Dates (important events)

Enumeration Date: 01/11/2021
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20399 RT 19 STE 120
CRANBERRY TWP PA
16066
US

IV. Provider business mailing address

128 HOMER CIRCLE
MCKEES ROCKS PA
15136
US

V. Phone/Fax

Practice location:
  • Phone: 724-709-4667
  • Fax:
Mailing address:
  • Phone: 724-709-4667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC014938
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC014938
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: