Provider Demographics
NPI:1699951228
Name:MILLER, ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35629 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-4619
Mailing Address - Country:US
Mailing Address - Phone:302-604-9677
Mailing Address - Fax:
Practice Address - Street 1:550 S DUPONT BLVD STE F
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1704
Practice Address - Country:US
Practice Address - Phone:302-422-2228
Practice Address - Fax:302-422-3888
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2023-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00010171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD705371101Medicaid