Provider Demographics
NPI:1598910069
Name:MILLER, SHAYNA LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:SHAYNA
Middle Name:LYNN
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 1:1110 M ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-9586
Mailing Address - Country:US
Mailing Address - Phone:970-353-6010
Mailing Address - Fax:970-353-5636
Practice Address - Street 1:1110 M ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-9586
Practice Address - Country:US
Practice Address - Phone:970-353-6010
Practice Address - Fax:970-353-5636
Is Sole Proprietor?:No
Enumeration Date:2008-11-24
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3315101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health