Provider Demographics
NPI:1871995241
Name:MILLER, CAROLYN (MED, CRC, LPC)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MED, CRC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 N FRANKLIN DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-5893
Mailing Address - Country:US
Mailing Address - Phone:724-222-2265
Mailing Address - Fax:724-222-2254
Practice Address - Street 1:2111 N FRANKLIN DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-5893
Practice Address - Country:US
Practice Address - Phone:724-222-2265
Practice Address - Fax:724-222-2254
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA00016461101Y00000X
PAPC001182101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor