Provider Demographics
NPI:1356231138
Name:MILLER, STACY
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:MILLER
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MAGGIES WAY STE 2
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-4896
Mailing Address - Country:US
Mailing Address - Phone:302-450-3217
Mailing Address - Fax:302-883-8192
Practice Address - Street 1:25 MAGGIES WAY STE 2
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4896
Practice Address - Country:US
Practice Address - Phone:302-450-3217
Practice Address - Fax:302-883-8192
Is Sole Proprietor?:No
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker