Healthcare Provider Details

I. General information

NPI: 1972525731
Provider Name (Legal Business Name): NANCY REGINA FRANCES MILLER LPC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 02/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8420 DORSEY CIR SUITE 102
MANASSAS VA
20110-8300
US

IV. Provider business mailing address

8420 DORSEY CIR SUITE 102
MANASSAS VA
20110-8300
US

V. Phone/Fax

Practice location:
  • Phone: 703-365-2144
  • Fax: 703-365-9006
Mailing address:
  • Phone: 703-365-2144
  • Fax: 703-365-9006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701002693
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717000836
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number09-516310
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: