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General NPI Number Information
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NPI Number | 1902445463
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Entity Type | Individual
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Provider Name | EVAN MILLER LCAS-A, LPC-A
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Gender | Male
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Dates
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Enumeration Date | 01/02/2020
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Last Update Date | 01/02/2020
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Provider Practice Location Address
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Address Line | 7432 DARBLAY ST
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-1002
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Country | US
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Telephone | 704-253-3045
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Fax |
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Provider Business Mailing Address
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Address Line | 7432 DARBLAY ST
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-1002
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Country | US
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Telephone | 704-253-3045
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS24933
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License Number State | NC
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