Healthcare Provider Details

I. General information

NPI: 1891867842
Provider Name (Legal Business Name): PATTI ANN MILLER MA, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 05/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 ARDEN NOLLVILLE ROAD SUITE 5
INWOOD WV
25428-5353
US

IV. Provider business mailing address

329 ARDEN NOLLVILLE ROAD SUITE 5
INWOOD WV
25428-5353
US

V. Phone/Fax

Practice location:
  • Phone: 304-582-5888
  • Fax: 304-267-1012
Mailing address:
  • Phone: 304-582-5888
  • Fax: 304-267-1012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1112
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1112
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: