Provider Demographics
NPI:1598028805
Name:MILLER, GEORGINE Y (LPC)
Entity Type:Individual
Prefix:MS
First Name:GEORGINE
Middle Name:Y
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 1:639 S. FRONT ST.,
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN,
Mailing Address - State:PA
Mailing Address - Zip Code:18103
Mailing Address - Country:US
Mailing Address - Phone:610-797-6098
Mailing Address - Fax:
Practice Address - Street 1:10 S. 13TH ST.,
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ALLENTOWN,
Practice Address - State:PA
Practice Address - Zip Code:18102
Practice Address - Country:US
Practice Address - Phone:610-740-3031
Practice Address - Fax:610-740-3032
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000354101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor