Provider Demographics
NPI:1316818305
Name:MILLER, SADIE ANN
Entity type:Individual
Prefix:
First Name:SADIE
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SADIE
Other - Middle Name:ANN
Other - Last Name:PILE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 444
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:CO
Mailing Address - Zip Code:80860-0444
Mailing Address - Country:US
Mailing Address - Phone:620-290-5308
Mailing Address - Fax:
Practice Address - Street 1:100 W BENNETT AVE
Practice Address - Street 2:
Practice Address - City:CRIPPLE CREEK
Practice Address - State:CO
Practice Address - Zip Code:80813
Practice Address - Country:US
Practice Address - Phone:719-286-9077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0023029101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional