Mr Michael S Miller, LPC | |
204 Mississippi St S, Wynne, AR 72396-3025 | |
(870) 208-8499 | |
Not Available |
Full Name | Mr Michael S Miller |
---|---|
Gender | Male |
Speciality | Counselor - Professional |
Location | 204 Mississippi St S, Wynne, Arkansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396998605 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | P1412114 (Arkansas) | Primary |
183700000X | Pharmacy Technician | (* (Not Available)) | Secondary |
Entity Name | Changes Behavioral Health, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1114260486 PECOS PAC ID: 6103149653 Enrollment ID: O20150108001118 |
Mailing Address | Practice Location Address |
---|---|
Mr Michael S Miller, LPC 6462 Crossbrook Ln Apt 5, Memphis, TN 38134-7896 Ph: (501) 519-2482 | Mr Michael S Miller, LPC 204 Mississippi St S, Wynne, AR 72396-3025 Ph: (870) 208-8499 |
Mrs. Millie F. Lace, MSE, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 202 Commercial Ave E, Wynne, AR 72396 Phone: 870-238-4329 Fax: 870-208-8935 | |
David M Ray, LPC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1792 Falls Blvd N, Ste. 5, Wynne, AR 72396 Phone: 870-208-9333 Fax: 870-208-9229 | |
Tabatha Bradley, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 204 Mississippi St S, Wynne, AR 72396 Phone: 870-208-8499 | |
Kayla Baker, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1200 Bridges Ave E, Wynne, AR 72396 Phone: 870-336-1300 | |
Katelyn Boles, LPC Counselor Medicare: Medicare Enrolled Practice Location: 206 Levesque Ave E, Wynne, AR 72396 Phone: 870-351-0312 | |
Amanda Turnbow, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1792 Falls Blvd N, Wynne, AR 72396 Phone: 870-208-9333 |