Provider Demographics
NPI:1467054858
Name:MILLER, MAQUEL RAKIA (LCPC)
Entity Type:Individual
Prefix:
First Name:MAQUEL
Middle Name:RAKIA
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 OLD SOLOMONS ISLAND RD STE L8
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3828
Mailing Address - Country:US
Mailing Address - Phone:410-696-4740
Mailing Address - Fax:
Practice Address - Street 1:108 OLD SOLOMONS ISLAND RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3845
Practice Address - Country:US
Practice Address - Phone:410-696-4740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10761101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLC10761OtherBOPC