1104957216 NPI number — MRS. ANDREA HOWARD MILLER M.S., ED.S., LCMHCS

Table of content: MRS. ANDREA HOWARD MILLER M.S., ED.S., LCMHCS (NPI 1104957216)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104957216 NPI number — MRS. ANDREA HOWARD MILLER M.S., ED.S., LCMHCS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLER
Provider First Name:
ANDREA
Provider Middle Name:
HOWARD
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., ED.S., LCMHCS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CONSULTING
Provider Other First Name:
AHM
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PLLC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1104957216
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
495 CHALK MAPLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHINA GROVE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28023-1508
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-640-8921
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17015 KENTON DR STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORNELIUS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28031-5561
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-572-9286
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: S6708 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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