Provider Demographics
NPI:1316950983
Name:VER MILLER, MATTHEW (PSYD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:VER MILLER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 281071
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1071
Mailing Address - Country:US
Mailing Address - Phone:303-519-0501
Mailing Address - Fax:720-509-1609
Practice Address - Street 1:445 UNION BLVD
Practice Address - Street 2:SUITE 238
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1237
Practice Address - Country:US
Practice Address - Phone:303-519-0501
Practice Address - Fax:720-509-1609
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2948103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical