Provider Demographics
NPI:1437514080
Name:MILLER, NICKIA (LADC, LCSW)
Entity Type:Individual
Prefix:
First Name:NICKIA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LADC, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 CROSSROADS PLZ STE 180
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-2402
Mailing Address - Country:US
Mailing Address - Phone:860-805-0245
Mailing Address - Fax:
Practice Address - Street 1:39 DEAR MEADOW DRIVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002
Practice Address - Country:US
Practice Address - Phone:860-805-0245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-28
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12263101YM0800X
CT1121101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)