Provider Demographics
NPI:1033854872
Name:MILLER, CARRIE A (MSW, LSW, RCSW-I)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:A
Last Name:MILLER
Suffix:
Gender:F
Credentials:MSW, LSW, RCSW-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 37TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-2022
Mailing Address - Country:US
Mailing Address - Phone:317-313-7525
Mailing Address - Fax:
Practice Address - Street 1:5201 37TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-2022
Practice Address - Country:US
Practice Address - Phone:317-313-7525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000000OtherNA