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NPI Code Detail

MEDICARE: MRS. CAROLE L MILLER LCSW-C

MEDICARE: MRS. CAROLE L MILLER LCSW-C
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
11041C0700XClinical Social Worker10806MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
115448OTHERAZLCSW - BOARD OF BEHAVIORAL HEALTH EXAMINERS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063546950
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROLE L MILLER LCSW-C
Provider Business Mailing Address
First Line : 10400 SHAKER DRIVE
Second Line : SUITE 326
City : SIMPSONVILLE
State : MD
Zip : 21150
Country : US
Telephone Number : 443-545-1611
Fax Number : 443-632-3946
Provider Business Practice Location Address
First Line : 9780 PATUXENT WOODS DR
Second Line :
City : COLUMBIA
State : MD
Zip : 21046-1526
Country : US
Telephone Number : 410-313-1764
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2007
Last Update Date : 09/30/2019

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