Provider Demographics
NPI:1346355591
Name:MILLER, KATHLEEN ANN (LSCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 N LORRAINE ST STE 202
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67501-5600
Mailing Address - Country:US
Mailing Address - Phone:620-663-7595
Mailing Address - Fax:620-513-5098
Practice Address - Street 1:602 E 2ND ST
Practice Address - Street 2:
Practice Address - City:PRATT
Practice Address - State:KS
Practice Address - Zip Code:67124-2912
Practice Address - Country:US
Practice Address - Phone:620-672-2332
Practice Address - Fax:620-672-3162
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4080104100000X
KS46141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker