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General NPI Number Information
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NPI Number | 1184141160
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Entity Type | Individual
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Provider Name | KEYADD MILLER LCSWA
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Gender | Male
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Dates
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Enumeration Date | 08/29/2017
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 233 S SHARON AMITY RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-2880
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Country | US
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Telephone | 980-613-8474
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Fax | 704-709-8580
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Provider Business Mailing Address
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Address Line | 886 BRUNSWICK DR
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City | ROCK HILL
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State | SC
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Zip | 29730-5782
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Country | US
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Telephone | 803-370-5507
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Fax | 704-709-8580
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P021357
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License Number State | NC
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