Provider Demographics
NPI:1033833090
Name:MILLER, SYDNEE ASHTON (LMSW)
Entity type:Individual
Prefix:
First Name:SYDNEE
Middle Name:ASHTON
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5011 GLENWOOD ST APT 7
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-4638
Mailing Address - Country:US
Mailing Address - Phone:816-510-0131
Mailing Address - Fax:
Practice Address - Street 1:4571 N MARKET ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71107-2917
Practice Address - Country:US
Practice Address - Phone:318-429-6938
Practice Address - Fax:318-424-8739
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17528104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA17M0000XMedicaid