Provider Demographics
NPI:1598002172
Name:MILLER, ASHLEY NICOLE BROOKE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:NICOLE BROOKE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1095
Mailing Address - Street 2:
Mailing Address - City:EDENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27932-1095
Mailing Address - Country:US
Mailing Address - Phone:252-368-6110
Mailing Address - Fax:
Practice Address - Street 1:1255 HAUGHTON ROAD
Practice Address - Street 2:
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932
Practice Address - Country:US
Practice Address - Phone:252-368-6110
Practice Address - Fax:252-661-4027
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9429101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional