Provider Demographics
NPI:1619201498
Name:MILLER, CORTNEY ANNE (LCSW, LCAC)
Entity Type:Individual
Prefix:
First Name:CORTNEY
Middle Name:ANNE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1958 S COUNTY ROAD 400 W
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:46135-8282
Mailing Address - Country:US
Mailing Address - Phone:919-600-2778
Mailing Address - Fax:866-544-8850
Practice Address - Street 1:1208 S BLOOMINGTON ST STE B
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:IN
Practice Address - Zip Code:46135-2269
Practice Address - Country:US
Practice Address - Phone:919-600-2778
Practice Address - Fax:866-544-8850
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87001194A101YA0400X
IN34005686A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)