Provider Demographics
NPI:1366521619
Name:MILLER, RONALD D (LCPC,LCADC)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:D
Last Name:MILLER
Suffix:
Gender:M
Credentials:LCPC,LCADC
Other - Prefix:MR
Other - First Name:RONALD
Other - Middle Name:D
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC,LCADC
Mailing Address - Street 1:201 INDIAN SPRING DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-3111
Mailing Address - Country:US
Mailing Address - Phone:301-565-3932
Mailing Address - Fax:
Practice Address - Street 1:201 INDIAN SPRING DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-3111
Practice Address - Country:US
Practice Address - Phone:301-565-3932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCA296101YA0400X
MDLC0206101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health