| Jean Miller Lcsw Llc | |
|
117 S 5th St Goshen IN 46528-3711 | |
| (574) 238-1566 | |
| Not Available |
| Full Name | Jean Miller Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 117 S 5th St, Goshen, Indiana |
| Authorized Official Name and Position | Jean Miller (OWNER) |
| Authorized Official Contact | 5742381566 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jean Miller Lcsw Llc 117 S 5th St Goshen IN 46528-3711 Ph: (574) 238-1566 | Jean Miller Lcsw Llc 117 S 5th St Goshen IN 46528-3711 Ph: (574) 238-1566 |
| NPI Number | 1932809993 |
|---|---|
| Provider Enumeration Date | 03/08/2023 |
| Last Update Date | 03/08/2023 |
| Certification Date | 03/08/2023 |
| Medicare PECOS PAC ID | 6204291933 |
|---|---|
| Medicare Enrollment ID | O20230502000367 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932809993 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jean K Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477589208 PECOS PAC ID: 1355381583 Enrollment ID: I20050506000695 |
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