Provider Demographics
NPI:1194747931
Name:MILLER, JAMES STEVEN (MA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:STEVEN
Last Name:MILLER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1984 ISAAC NEWTON SQ W
Mailing Address - Street 2:SUITE 204
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5038
Mailing Address - Country:US
Mailing Address - Phone:703-987-3330
Mailing Address - Fax:703-464-8669
Practice Address - Street 1:1984 ISAAC NEWTON SQ W
Practice Address - Street 2:SUITE 204
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5038
Practice Address - Country:US
Practice Address - Phone:703-987-3330
Practice Address - Fax:703-464-8669
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003901101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701003901OtherLPC STATE LICENSE