Provider Demographics
NPI:1497162093
Name:MILLER, LAURIE LOOPE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:LOOPE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11230 WAPLES MILL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6087
Mailing Address - Country:US
Mailing Address - Phone:703-591-1146
Mailing Address - Fax:703-591-1148
Practice Address - Street 1:11230 WAPLES MILL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6087
Practice Address - Country:US
Practice Address - Phone:703-591-1146
Practice Address - Fax:703-591-1148
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040060181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical