Healthcare Provider Details

I. General information

NPI: 1275288052
Provider Name (Legal Business Name): BENJAMIN MILLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2022
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 FEDERAL ST STE 305
PITTSBURGH PA
15212-4769
US

IV. Provider business mailing address

1307 FEDERAL ST STE 305
PITTSBURGH PA
15212-4769
US

V. Phone/Fax

Practice location:
  • Phone: 412-330-4000
  • Fax:
Mailing address:
  • Phone: 412-330-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC014454
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: