MEDICARE: ZAHIRA AMANDA MILLER 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	0086231	NM
2	101YP2500X	Professional Counselor	125681	NM

General Provider Information

NPI Number	:	1497939466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZAHIRA AMANDA MILLER LPCC

Provider Business Mailing Address
First Line	:	PO BOX 2267
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87504-2267
Country	:	US
Telephone Number	:	505-467-2925
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 YUCCA ST
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-5456
Country	:	US
Telephone Number	:	505-467-2925
Fax Number	:

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

Provider Enumeration Date	:	12/26/2007
Last Update Date	:	10/18/2021

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