Provider Demographics
NPI:1679582472
Name:MILLER, KAREN S (PHD,LPC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHD,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CRESTWOOD EXECUTIVE CTR
Mailing Address - Street 2:SUITE 207
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-1945
Mailing Address - Country:US
Mailing Address - Phone:314-729-1850
Mailing Address - Fax:314-729-1807
Practice Address - Street 1:50 CRESTWOOD EXECUTIVE CTR
Practice Address - Street 2:SUITE 207
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-1945
Practice Address - Country:US
Practice Address - Phone:314-729-1850
Practice Address - Fax:314-729-1807
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000063101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health