Provider Demographics
NPI:1154582690
Name:MILLER, ANNA KATE (LCSW)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:KATE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 FIELDTRIAL CIR
Mailing Address - Street 2:GARNER
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-6537
Mailing Address - Country:US
Mailing Address - Phone:404-664-5110
Mailing Address - Fax:
Practice Address - Street 1:226 FIELDTRIAL CIR
Practice Address - Street 2:GARNER
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-6537
Practice Address - Country:US
Practice Address - Phone:404-664-5110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0089061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC008906OtherNC PROFESSIONAL SOCIAL WORK LICENSE
GACSW003486OtherSTATE LICENSE