Provider Demographics
NPI:1073963765
Name:MILLER, STEPHANIE AMBER (MRC, CRC, LPCC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:AMBER
Last Name:MILLER
Suffix:
Gender:F
Credentials:MRC, CRC, LPCC
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:AMBER
Other - Last Name:CASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MRC CRC
Mailing Address - Street 1:1168 FOUR WYNDS TRL
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-1570
Mailing Address - Country:US
Mailing Address - Phone:502-724-1573
Mailing Address - Fax:
Practice Address - Street 1:1168 FOUR WYNDS TRL
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40515-1570
Practice Address - Country:US
Practice Address - Phone:502-724-1573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYLPCPCC00225635101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health