| John D Miller Ms Lpc Llc | |
|
701 W Broad St Ste 207 Bethlehem PA 18018-5229 | |
| (484) 893-0535 | |
| Not Available |
| Full Name | John D Miller Ms Lpc Llc |
|---|---|
| Speciality | Counselor |
| Location | 701 W Broad St Ste 207, Bethlehem, Pennsylvania |
| Authorized Official Name and Position | John Miller (OWNER OPERATOR) |
| Authorized Official Contact | 4845549459 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John D Miller Ms Lpc Llc 701 W Broad St Ste 207 Bethlehem PA 18018-5229 Ph: (484) 893-0535 | John D Miller Ms Lpc Llc 701 W Broad St Ste 207 Bethlehem PA 18018-5229 Ph: (484) 893-0535 |
| NPI Number | 1609402254 |
|---|---|
| Provider Enumeration Date | 03/16/2020 |
| Last Update Date | 09/08/2023 |
| Certification Date | 09/08/2023 |
| Medicare PECOS PAC ID | 0042656266 |
|---|---|
| Medicare Enrollment ID | O20240311002241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609402254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | John D Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407202310 PECOS PAC ID: 0648616862 Enrollment ID: I20240311002487 |
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