Provider Demographics
NPI:1306288196
Name:MILLER, DARCIA CLARICE (LMSW)
Entity type:Individual
Prefix:
First Name:DARCIA
Middle Name:CLARICE
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 1:25600 WOODWARD AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-0945
Mailing Address - Country:US
Mailing Address - Phone:248-399-7447
Mailing Address - Fax:586-792-1656
Practice Address - Street 1:25600 WOODWARD AVE STE 215
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-0945
Practice Address - Country:US
Practice Address - Phone:248-399-7447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL2516913104100000X
MI68010956981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker