Provider Demographics
NPI:1073400131
Name:MILLER, MAYA (LMSW)
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2622 N VAN DORN ST APT 101
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-1619
Mailing Address - Country:US
Mailing Address - Phone:704-698-7094
Mailing Address - Fax:
Practice Address - Street 1:2622 N VAN DORN ST APT 101
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-1619
Practice Address - Country:US
Practice Address - Phone:704-698-7094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-21
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0903004560104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker