Provider Demographics
NPI: | 1467008060 |
---|---|
Name: | MILLER, CHRISTEN |
Entity Type: | Individual |
Prefix: | |
First Name: | CHRISTEN |
Middle Name: | |
Last Name: | MILLER |
Suffix: | |
Gender: | F |
Credentials: | |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 5241 BEAVER CREEK DR |
Mailing Address - Street 2: | |
Mailing Address - City: | FAYETTEVILLE |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 28303-3201 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 910-578-5458 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2352 S CHURCH ST |
Practice Address - Street 2: | |
Practice Address - City: | BURLINGTON |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27215-5332 |
Practice Address - Country: | US |
Practice Address - Phone: | 910-578-5458 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2019-08-11 |
Last Update Date: | 2019-08-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No | 101YP1600X | Behavioral Health & Social Service Providers | Counselor | Pastoral |
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional |
No | 101YS0200X | Behavioral Health & Social Service Providers | Counselor | School |
No | 102L00000X | Behavioral Health & Social Service Providers | Psychoanalyst | |
No | 102X00000X | Behavioral Health & Social Service Providers | Poetry Therapist | |
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | |
No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | |
No | 171000000X | Other Service Providers | Military Health Care Provider | |
No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | |
No | 175T00000X | Other Service Providers | Peer Specialist | |
No | 221700000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Art Therapist | |
No | 225XM0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Mental Health |
No | 372600000X | Nursing Service Related Providers | Adult Companion |