Provider Demographics
NPI:1497272793
Name:MILLER, LAURA VIRGINIA (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:VIRGINIA
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 1:37 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-3645
Mailing Address - Country:US
Mailing Address - Phone:301-697-0289
Mailing Address - Fax:
Practice Address - Street 1:300 E OLDTOWN RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-3600
Practice Address - Country:US
Practice Address - Phone:301-777-8685
Practice Address - Fax:301-777-8687
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2017-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6527101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional