Provider Demographics
NPI:1578960530
Name:MILLER PROFESSIONAL COUNSELING, P.C.
Entity Type:Organization
Organization Name:MILLER PROFESSIONAL COUNSELING, P.C.
Other - Org Name:MATT MILLER COACHING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/COUNSELOR/COACH
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, ADC, ICADC
Authorized Official - Phone:256-882-2601
Mailing Address - Street 1:600 BOULEVARD SOUTH SW
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-2113
Mailing Address - Country:US
Mailing Address - Phone:256-882-2601
Mailing Address - Fax:
Practice Address - Street 1:415E CHURCH ST NW
Practice Address - Street 2:SUITE 11
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5578
Practice Address - Country:US
Practice Address - Phone:256-882-2601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2472101Y00000X
AL388101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty