Provider Demographics
NPI:1568867364
Name:MILLER, ASHLEY (LMHC, CAP, MED)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMHC, CAP, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6662 GREEN ISLAND CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-7001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5511 S CONGRESS AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-1140
Practice Address - Country:US
Practice Address - Phone:561-304-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6041101YA0400X
FLMH13499101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)