Provider Demographics
NPI:1508915265
Name:MILLER, WILLIAM STANDISH (PHD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:STANDISH
Last Name:MILLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25700 SCIENCE PARK DRIVE, SUITE 200
Mailing Address - Street 2:LANDMARK CENTRE.
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-831-1040
Mailing Address - Fax:216-831-2667
Practice Address - Street 1:24100 CHAGRIN BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5535
Practice Address - Country:US
Practice Address - Phone:216-831-1040
Practice Address - Fax:216-831-2667
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6188103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist