Provider Demographics
NPI:1386482818
Name:MILLER, JENNIFER R (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12230 WASHINGTON CENTER PKWY APT 380
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-3681
Mailing Address - Country:US
Mailing Address - Phone:516-380-9122
Mailing Address - Fax:
Practice Address - Street 1:12230 WASHINGTON CENTER PKWY APT 380
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-3681
Practice Address - Country:US
Practice Address - Phone:516-380-9122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical