Provider Demographics
NPI:1558904326
Name:DE MILLER COUNSELING AND CONSULTING
Entity Type:Organization
Organization Name:DE MILLER COUNSELING AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DALAYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-923-7130
Mailing Address - Street 1:1862 OAK HILL SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-5217
Mailing Address - Country:US
Mailing Address - Phone:678-923-7130
Mailing Address - Fax:
Practice Address - Street 1:1862 OAK HILL SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-5217
Practice Address - Country:US
Practice Address - Phone:678-923-7130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty