Provider Demographics
NPI:1699152959
Name:MILLER, JAMIE MARIE (LPC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:MARIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5545
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-0545
Mailing Address - Country:US
Mailing Address - Phone:724-457-0858
Mailing Address - Fax:724-457-0867
Practice Address - Street 1:890 BEAVER GRADE RD
Practice Address - Street 2:UPPER LEVEL
Practice Address - City:MOON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15108-2653
Practice Address - Country:US
Practice Address - Phone:724-457-0858
Practice Address - Fax:724-457-0867
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007152101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional