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General NPI Number Information
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NPI Number | 1619134764
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Entity Type | Individual
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Provider Name | LINDA C MILLER LCSW, LMFT
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Gender | Female
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 01/18/2019
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Provider Practice Location Address
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Address Line | 4123 DUTCHMANS LN STE 503
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City | LOUISVILLE
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State | KY
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Zip | 40207-4730
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Country | US
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Telephone | 502-409-5600
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Fax | 502-259-3078
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Provider Business Mailing Address
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Address Line | 8911 GREENEWAY COMMONS PL SUITE 203
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City | LOUISVILLE
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State | KY
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Zip | 40220-4064
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Country | US
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Telephone | 502-741-9641
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5239
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0853
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5001
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License Number State | KY
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