Provider Demographics
NPI:1518037084
Name:MILLER, TERRENCE RICHARD (MA LPC CAADC)
Entity Type:Individual
Prefix:MR
First Name:TERRENCE
Middle Name:RICHARD
Last Name:MILLER
Suffix:
Gender:M
Credentials:MA LPC CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W. SOUTH BLVD.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307
Mailing Address - Country:US
Mailing Address - Phone:248-844-6234
Mailing Address - Fax:248-844-6237
Practice Address - Street 1:110 W. SOUTH BLVD.
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307
Practice Address - Country:US
Practice Address - Phone:248-844-6234
Practice Address - Fax:248-844-6237
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401005673101YA0400X, 101YP2500X
MIC-01181101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)