Provider Demographics
NPI:1932338092
Name:MILLER, NORMA JOAN (LCPC, RDDP)
Entity type:Individual
Prefix:MS
First Name:NORMA
Middle Name:JOAN
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCPC, RDDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 N LAKE SHORE DR
Mailing Address - Street 2:APT. 1206B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-3408
Mailing Address - Country:US
Mailing Address - Phone:773-883-1452
Mailing Address - Fax:847-455-0744
Practice Address - Street 1:3950 N LAKE SHORE DR
Practice Address - Street 2:APT. 1206B
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-3408
Practice Address - Country:US
Practice Address - Phone:773-883-1452
Practice Address - Fax:847-455-0744
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2009-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL26099101YA0400X
IL180000610101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health