Provider Demographics
NPI:1083055115
Name:MILLER, THOMAS C (PSYD, PSY)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:C
Last Name:MILLER
Suffix:
Gender:M
Credentials:PSYD, PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 KENSINGTON PL APT H
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2285
Mailing Address - Country:US
Mailing Address - Phone:513-313-3633
Mailing Address - Fax:
Practice Address - Street 1:1700 KENSINGTON PL APT H
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2285
Practice Address - Country:US
Practice Address - Phone:513-313-3633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0004467103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical