Provider Demographics
NPI:1902128432
Name:MILLER, DANIEL E (LCMHC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:MILLER
Suffix:
Gender:
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 CALEDONIA ST
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-2469
Mailing Address - Country:US
Mailing Address - Phone:802-535-1997
Mailing Address - Fax:
Practice Address - Street 1:117 MANCHESTER ST STE 5A
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5101
Practice Address - Country:US
Practice Address - Phone:603-606-9357
Practice Address - Fax:603-217-2075
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2536101YM0800X
VT068.0110025101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT068.0110025OtherSTATE OF VERMONT LICENSE
NH3137884Medicaid