Provider Demographics
NPI:1275201550
Name:MILLER, CHRISTA E (LMSW, LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:E
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 S ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-6446
Mailing Address - Country:US
Mailing Address - Phone:660-221-5823
Mailing Address - Fax:
Practice Address - Street 1:1210 S ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-6446
Practice Address - Country:US
Practice Address - Phone:660-221-5823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20200135111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical