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General NPI Number Information
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NPI Number | 1518104785
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Entity Type | Organization
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Legal Business Name | MILLER COUNSELING INC
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Dates
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Enumeration Date | 01/09/2009
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Last Update Date | 01/09/2009
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Provider Practice Location Address
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Address Line | 170 FRANK E SIMON AVE
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City | SHEPHERDSVILLE
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State | KY
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Zip | 40165-6547
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Country | US
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Telephone | 502-543-1009
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Fax | 502-921-9762
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Provider Business Mailing Address
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Address Line | PO BOX 850
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City | SHEPHERDSVILLE
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State | KY
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Zip | 40165-0850
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Country | US
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Telephone | 502-543-1009
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Fax | 502-921-9762
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | TERESA LUSTER
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Credential | CPC
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Telephone | 502-543-4100
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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 | 1394
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License Number State | KY
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