Provider Demographics
NPI:1912533415
Name:MILLER, STACEY MICHELLE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:MICHELLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:STACEY
Other - Middle Name:MICHELLE
Other - Last Name:MEIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:5855 SW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-2463
Mailing Address - Country:US
Mailing Address - Phone:785-224-8665
Mailing Address - Fax:
Practice Address - Street 1:5855 SW 29TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-2463
Practice Address - Country:US
Practice Address - Phone:785-224-8665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-16
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS064741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical