Provider Demographics
NPI:1336649698
Name:MILLER, AMANDA (LCSW, CACII)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 E FLORIDA AVE STE 650
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-2562
Mailing Address - Country:US
Mailing Address - Phone:970-460-6013
Mailing Address - Fax:
Practice Address - Street 1:3801 E FLORIDA AVE STE 650
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-2562
Practice Address - Country:US
Practice Address - Phone:704-606-0139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-13
Last Update Date:2020-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACB.0008146101YA0400X
COCSW.099251341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)