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General NPI Number Information
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NPI Number | 1881948503
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Entity Type | Organization
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Legal Business Name | ELLEN M. MILLER, LCSW-C, LLC
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Dates
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Enumeration Date | 11/02/2012
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Last Update Date | 11/02/2012
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Provider Practice Location Address
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Address Line | 6320 DEMOCRACY BLVD
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City | BETHESDA
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State | MD
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Zip | 20817-1664
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Country | US
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Telephone | 301-309-8077
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Fax |
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Provider Business Mailing Address
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Address Line | 13 LE HAVRE CT
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City | POTOMAC
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State | MD
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Zip | 20854-3176
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Country | US
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Telephone | 301-309-8077
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ELLEN MARSHA MILLER
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Credential | LCSW-C
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Telephone | 301-309-8077
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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 | 08314
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License Number State | MD
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