Provider Demographics
NPI:1073652723
Name:MILLER, LAURA LEE (LPC, NCC, ATR, LCPC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LEE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPC, NCC, ATR, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 HIDDEN SPRING DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-8408
Mailing Address - Country:US
Mailing Address - Phone:314-610-9619
Mailing Address - Fax:
Practice Address - Street 1:121 HUNTER AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-2000
Practice Address - Country:US
Practice Address - Phone:314-610-9619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006001483101YP2500X
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional