Provider Demographics
NPI:1497389001
Name:MILLER, BRIAN (CSAC)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12124 BIRCHLEAF CIR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23146-1840
Mailing Address - Country:US
Mailing Address - Phone:804-836-3432
Mailing Address - Fax:
Practice Address - Street 1:2217 E FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-7046
Practice Address - Country:US
Practice Address - Phone:804-213-0249
Practice Address - Fax:804-716-0715
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health