Provider Demographics
NPI:1871657429
Name:MILLER, PATRICIA L (MA,LSW,LPCC)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:L
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA,LSW,LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3745 WHIPPLE AVE NW
Mailing Address - Street 2:SUITE A
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2933
Mailing Address - Country:US
Mailing Address - Phone:330-493-3313
Mailing Address - Fax:330-493-6413
Practice Address - Street 1:3745 WHIPPLE AVE NW
Practice Address - Street 2:SUITE A
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2933
Practice Address - Country:US
Practice Address - Phone:330-493-3313
Practice Address - Fax:330-493-6413
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE2292101YP2500X
OHS00168711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical