Provider Demographics
NPI:1164190641
Name:MILLER, AUSTIN DEAN (CT)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:DEAN
Last Name:MILLER
Suffix:
Gender:M
Credentials:CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 GRAHAM RD
Mailing Address - Street 2:UNIT 3
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-1155
Mailing Address - Country:US
Mailing Address - Phone:306-069-2623
Mailing Address - Fax:234-678-4858
Practice Address - Street 1:960 GRAHAM RD
Practice Address - Street 2:UNIT 3
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-1155
Practice Address - Country:US
Practice Address - Phone:306-069-2623
Practice Address - Fax:234-678-4858
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2304813101Y00000X
OHC.2103474-TRNE101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor