Provider Demographics
NPI:1477023786
Name:MILLER, ANNA SHADEA (LPC)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:SHADEA
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 1:5289 HILLTOP RD APT Q
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-5283
Mailing Address - Country:US
Mailing Address - Phone:336-558-5245
Mailing Address - Fax:
Practice Address - Street 1:5289 HILLTOP RD APT Q
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-5283
Practice Address - Country:US
Practice Address - Phone:336-558-5245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-29
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11846101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health