Provider Demographics
NPI:1528539889
Name:MILLER, ELIZABETH MARIE (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MARIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HECKSCHERSTR. 9
Mailing Address - Street 2:
Mailing Address - City:MUNICH
Mailing Address - State:BAVARIA
Mailing Address - Zip Code:80804
Mailing Address - Country:DE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HECKSCHERSTR. 9
Practice Address - Street 2:
Practice Address - City:MUNICH
Practice Address - State:BAVARIA
Practice Address - Zip Code:80804
Practice Address - Country:DE
Practice Address - Phone:004-989-1279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1027754-SW-LICSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
--------------------OtherI AM NOT CURRENTLY A PROVIDER.