Provider Demographics
NPI:1619416393
Name:WENDY C. MILLER, INC
Entity Type:Organization
Organization Name:WENDY C. MILLER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-932-0658
Mailing Address - Street 1:33 GALWAY CT
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-2403
Mailing Address - Country:US
Mailing Address - Phone:401-932-0658
Mailing Address - Fax:401-789-4487
Practice Address - Street 1:501 KINGSTOWN RD
Practice Address - Street 2:
Practice Address - City:WEST KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02892-1125
Practice Address - Country:US
Practice Address - Phone:401-932-0658
Practice Address - Fax:401-789-4487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW020731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty