Provider Demographics
NPI:1437866340
Name:MILLER, ABBY MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:MARIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6541 173RD PL APT 3
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-2000
Mailing Address - Country:US
Mailing Address - Phone:708-646-9113
Mailing Address - Fax:
Practice Address - Street 1:24047 W LOCKPORT ST STE 211
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-1682
Practice Address - Country:US
Practice Address - Phone:708-646-9113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.016351101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional