Provider Demographics
NPI:1588703136
Name:MILLER, COLLEEN PATRICIA (LMFT LPC)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:PATRICIA
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMFT LPC
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:PATRICIA
Other - Last Name:DUGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:705 E 41ST STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105
Mailing Address - Country:US
Mailing Address - Phone:605-357-0100
Mailing Address - Fax:605-357-0190
Practice Address - Street 1:705 E 41ST STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105
Practice Address - Country:US
Practice Address - Phone:605-357-0100
Practice Address - Fax:605-357-0190
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC 626101Y00000X
SDLMFT 1120101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor