Provider Demographics
NPI:1972132793
Name:MILLER, FALICIA (LMHCA)
Entity type:Individual
Prefix:
First Name:FALICIA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6525 E 82ND ST BLDG 10
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-1570
Mailing Address - Country:US
Mailing Address - Phone:317-696-5034
Mailing Address - Fax:
Practice Address - Street 1:6525 E 82ND ST BLDG 10
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1570
Practice Address - Country:US
Practice Address - Phone:317-696-5034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN880000575A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
INNONEOtherN/A