Provider Demographics
NPI:1417062480
Name:MILLER, RICHARD KEVIN (M ED)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:KEVIN
Last Name:MILLER
Suffix:
Gender:M
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:520 WASHINGTON RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MOUNT LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:15228-2819
Mailing Address - Country:US
Mailing Address - Phone:412-561-6776
Mailing Address - Fax:412-343-2130
Practice Address - Street 1:1720 WASHINGTON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:UPPER ST CLAIR
Practice Address - State:PA
Practice Address - Zip Code:15241-1208
Practice Address - Country:US
Practice Address - Phone:412-561-6776
Practice Address - Fax:412-343-2130
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007898L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1619196987OtherNPI GROUP
PA1485089OtherBLUE SHIELD
PA515431OtherBLUE CROSS
PA630614OtherHIGHMARK IN STATE
PA1417062480OtherNPI
PA630614OtherHIGHMARK IN STATE