Provider Demographics
NPI:1346566924
Name:MILLER, COLLEEN MARY (PA-LPC)
Entity type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:MARY
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA-LPC
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 159
Mailing Address - Street 2:
Mailing Address - City:EAST PGH
Mailing Address - State:PA
Mailing Address - Zip Code:15112-0159
Mailing Address - Country:US
Mailing Address - Phone:412-829-0709
Mailing Address - Fax:412-829-0709
Practice Address - Street 1:524 RIDGE AVE
Practice Address - Street 2:CONSULTING SERVICES INC
Practice Address - City:EAST PGH
Practice Address - State:PA
Practice Address - Zip Code:15112
Practice Address - Country:US
Practice Address - Phone:412-829-0709
Practice Address - Fax:412-829-0709
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001609101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor