MEDICARE: MRS. STEPHANIE AMBER MILLER MRC, CRC, LPCC

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	101YM0800X	Mental Health Counselor	LPCPCC00225635	KY

General Provider Information

NPI Number	:	1073963765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEPHANIE AMBER MILLER MRC, CRC, LPCC

Provider Business Mailing Address
First Line	:	1168 FOUR WYNDS TRL
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40515-1570
Country	:	US
Telephone Number	:	502-724-1573
Fax Number	:

Provider Business Practice Location Address
First Line	:	1168 FOUR WYNDS TRL
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40515-1570
Country	:	US
Telephone Number	:	502-724-1573
Fax Number	:

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

Provider Enumeration Date	:	06/14/2016
Last Update Date	:	06/14/2016

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