Provider Demographics
NPI:1619134764
Name:MILLER, LINDA C (LCSW, LMFT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:C
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8911 GREENEWAY COMMONS PL
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-4064
Mailing Address - Country:US
Mailing Address - Phone:502-741-9641
Mailing Address - Fax:
Practice Address - Street 1:4123 DUTCHMANS LN STE 503
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4730
Practice Address - Country:US
Practice Address - Phone:502-409-5600
Practice Address - Fax:502-259-3078
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN52391041C0700X
KY0853106H00000X
KY50011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist