Provider Demographics
NPI:1578598165
Name:MILLER, LINDA (CAGS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 BENEFIT ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-2724
Mailing Address - Country:US
Mailing Address - Phone:401-272-0016
Mailing Address - Fax:
Practice Address - Street 1:98 BENEFIT ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-2724
Practice Address - Country:US
Practice Address - Phone:401-272-0016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI10101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health