Provider Demographics
NPI:1487543815
Name:MILLER, ELISABETH (LGPC)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 GATEHOUSE CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-5663
Mailing Address - Country:US
Mailing Address - Phone:818-430-5336
Mailing Address - Fax:
Practice Address - Street 1:900A S MAIN ST # 105
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-5438
Practice Address - Country:US
Practice Address - Phone:818-430-5336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP16567101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health