Provider Demographics
NPI:1386995215
Name:MILLER, KATHRYN S (LCSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:S
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 1:237 W LANCASTER AVE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:DEVON
Mailing Address - State:PA
Mailing Address - Zip Code:19333-1592
Mailing Address - Country:US
Mailing Address - Phone:267-225-4325
Mailing Address - Fax:
Practice Address - Street 1:237 W LANCASTER AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:DEVON
Practice Address - State:PA
Practice Address - Zip Code:19333-1592
Practice Address - Country:US
Practice Address - Phone:267-225-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW016254101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional