Provider Demographics
NPI:1407554058
Name:MILLER, BRIANNA LASHAY (MSW, CSW)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LASHAY
Last Name:MILLER
Suffix:
Gender:
Credentials:MSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CHINABERRY DR STE 900
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-2455
Mailing Address - Country:US
Mailing Address - Phone:318-315-0778
Mailing Address - Fax:
Practice Address - Street 1:690 SAN ANTONIO AVE STE A
Practice Address - Street 2:
Practice Address - City:MANY
Practice Address - State:LA
Practice Address - Zip Code:71449-3029
Practice Address - Country:US
Practice Address - Phone:318-256-5200
Practice Address - Fax:318-256-5201
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA672883104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker