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NPI Code Detail

MEDICARE: TARA M MILLER CDCA

MEDICARE: TARA M MILLER CDCA
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
1101YA0400XAddiction (Substance Use Disorder) Counselor183172OH
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1174280762
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA M MILLER CDCA
Provider Business Mailing Address
First Line : 110 HIGHLAND AVE
Second Line :
City : CIRCLEVILLE
State : OH
Zip : 43113-1208
Country : US
Telephone Number : 740-313-7513
Fax Number : 740-313-7514
Provider Business Practice Location Address
First Line : 780 GREGG ST
Second Line :
City : WASHINGTON COURT HOUSE
State : OH
Zip : 43160-1564
Country : US
Telephone Number : 740-313-7513
Fax Number : 740-313-7514
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2021
Last Update Date : 03/05/2026

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