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General NPI Number Information
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NPI Number | 1215014774
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Entity Type | Individual
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Provider Name | SUSAN PATRICIA MILLER LPC,NCC
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1225 MARTHA CUSTIS DR SUITE 2
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City | ALEXANDRIA
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State | VA
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Zip | 22302-2000
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Country | US
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Telephone | 703-845-0666
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Fax |
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Provider Business Mailing Address
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Address Line | 204 MONCURE DR
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City | ALEXANDRIA
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State | VA
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Zip | 22314-4911
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Country | US
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Telephone | 703-683-1414
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701002874
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License Number State | VA
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