Provider Demographics
NPI:1467704700
Name:MILLER, CHERYL R (LCPC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:R
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:R
Other - Last Name:BERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1190 MOUNT AETNA RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6833
Mailing Address - Country:US
Mailing Address - Phone:240-490-4309
Mailing Address - Fax:240-490-8528
Practice Address - Street 1:1190 MOUNT AETNA RD
Practice Address - Street 2:SUITE 300
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6833
Practice Address - Country:US
Practice Address - Phone:240-490-4309
Practice Address - Fax:240-490-8528
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4644101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional