Provider Demographics
NPI:1588263651
Name:MILLER, KATY (MS, LPC, NCC)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VICTORIA, FLAT 7
Mailing Address - Street 2:TRIQ GUZE MUSCAT
Mailing Address - City:NAXXAR
Mailing Address - State:- SELECT -
Mailing Address - Zip Code:NXR1460
Mailing Address - Country:MT
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:VICTORIA, FLAT 7
Practice Address - Street 2:TRIQ GUZE MUSCAT
Practice Address - City:NAXXAR
Practice Address - State:- SELECT -
Practice Address - Zip Code:NXR1460
Practice Address - Country:MT
Practice Address - Phone:475-223-1403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4618101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional