MEDICARE: LISA MILLER PHARMD, NCC, LCMHCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1300X	Psychiatric Pharmacist	PS30352	FL
2	101YM0800X	Mental Health Counselor	A16643	NC
3	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	15347	NC

General Provider Information

NPI Number	:	1013230580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA MILLER PHARMD, NCC, LCMHCA

Provider Business Mailing Address
First Line	:	5238 HAMMOCK POINTE CT
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34771-8796
Country	:	US
Telephone Number	:	704-807-9523
Fax Number	:

Provider Business Practice Location Address
First Line	:	5113 PIPER STATION DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-6689
Country	:	US
Telephone Number	:	704-807-9523
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2010
Last Update Date	:	06/08/2026

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