Provider Demographics
NPI:1205375177
Name:MILLER, MEGAN KAYE (LPC, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:KAYE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 175
Mailing Address - Street 2:201 STOCKWELL STREET
Mailing Address - City:PUKWANA
Mailing Address - State:SD
Mailing Address - Zip Code:57370-0175
Mailing Address - Country:US
Mailing Address - Phone:605-351-3718
Mailing Address - Fax:
Practice Address - Street 1:610 E 7TH STREET
Practice Address - Street 2:
Practice Address - City:PLATTE
Practice Address - State:SD
Practice Address - Zip Code:57369
Practice Address - Country:US
Practice Address - Phone:605-337-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC7426101YP2500X
SDLMFT1229106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist