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General NPI Number Information
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NPI Number | 1265562037
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Entity Type | Individual
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Provider Name | KATHLEEN M MILLER MS LPC CSAC ICS LCPC
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 01/31/2017
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Provider Practice Location Address
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Address Line | 3246 W. ROLLINGWOOD DRIVE
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City | JANESVILLE
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State | WI
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Zip | 53545-9030
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Country | US
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Telephone | 608-563-5633
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Fax | 608-563-4122
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Provider Business Mailing Address
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Address Line | 3246 W ROLLINGWOOD DR
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City | JANESVILLE
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State | WI
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Zip | 53545-9030
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Country | US
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Telephone | 608-563-5633
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Fax | 608-563-4122
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 15139-132
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 15375-135
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2864125
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License Number State | WI
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