Provider Demographics
NPI:1235644436
Name:MILLER, KASEY (CAC I)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:CAC I
Other - Prefix:
Other - First Name:KASEY
Other - Middle Name:
Other - Last Name:DOAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7645 KLINE DR
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-3733
Mailing Address - Country:US
Mailing Address - Phone:303-590-5806
Mailing Address - Fax:
Practice Address - Street 1:8801 LIPAN ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260-4912
Practice Address - Country:US
Practice Address - Phone:303-657-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-10
Last Update Date:2017-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACA.0007035101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)