Healthcare Provider Details

I. General information

NPI: 1871403121
Provider Name (Legal Business Name): CHADWICK MILLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 W 2ND ST N
LADYSMITH WI
54848-1338
US

IV. Provider business mailing address

PO BOX 68
MENOMONIE WI
54751-0068
US

V. Phone/Fax

Practice location:
  • Phone: 715-532-9771
  • Fax: 715-635-4861
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9289-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: