MEDICARE: LINDA J. MILLER-DOWIE, INC.

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	1041C0700X	Clinical Social Worker	SW0003011	FL

General Provider Information

NPI Number	:	1376671610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDA J. MILLER-DOWIE, INC.

Provider Business Mailing Address
First Line	:	572 MAGNOLIA ST
Second Line	:
City	:	NEPTUNE BEACH
State	:	FL
Zip	:	32266-3732
Country	:	US
Telephone Number	:	904-246-7196
Fax Number	:	904-246-5152

Provider Business Practice Location Address
First Line	:	2320 3RD ST S
Second Line	:	SUITE 3
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-4058
Country	:	US
Telephone Number	:	904-246-5001
Fax Number	:	904-246-5152

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. LINDA JUSTINE MILLER-DOWIE
Credential	:	MSW, LCSW, CEAP
Telephone Number	:	904-246-5001

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	09/25/2009

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