Provider Demographics
NPI:1104957216
Name:MILLER, ANDREA HOWARD (MS, EDS, LCMHCS)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:HOWARD
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, EDS, LCMHCS
Other - Prefix:
Other - First Name:AHM
Other - Middle Name:
Other - Last Name:CONSULTING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PLLC
Mailing Address - Street 1:495 CHALK MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:CHINA GROVE
Mailing Address - State:NC
Mailing Address - Zip Code:28023-1508
Mailing Address - Country:US
Mailing Address - Phone:704-640-8921
Mailing Address - Fax:
Practice Address - Street 1:17015 KENTON DR STE 203
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5561
Practice Address - Country:US
Practice Address - Phone:704-572-9286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NCS6708101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health