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NPI Code Detail

MEDICARE: KELLY TRACY MILLER MSW, LSW

MEDICARE: KELLY TRACY MILLER MSW, LSW
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 WorkerCSW.00001382CO

General Provider Information

NPI Number : 1417000134
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY TRACY MILLER MSW, LSW
Provider Business Mailing Address
First Line : 11349 W 27TH AVE
Second Line :
City : LAKEWOOD
State : CO
Zip : 80215-7106
Country : US
Telephone Number : 720-695-5809
Fax Number :
Provider Business Practice Location Address
First Line : 4704 HARLAN ST STE 511
Second Line :
City : DENVER
State : CO
Zip : 80212-7427
Country : US
Telephone Number : 720-675-7735
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 01/28/2026

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