Provider Demographics
NPI:1649401548
Name:MILLER, NAEISHA J (LCSW)
Entity Type:Individual
Prefix:
First Name:NAEISHA
Middle Name:J
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 SANDY PLAINS RD
Mailing Address - Street 2:BUILD 24 SUITE 100
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-7217
Mailing Address - Country:US
Mailing Address - Phone:678-362-7985
Mailing Address - Fax:678-466-7558
Practice Address - Street 1:2440 SANDY PLAINS RD
Practice Address - Street 2:BUILD 24 SUITE 100
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-7217
Practice Address - Country:US
Practice Address - Phone:678-362-7985
Practice Address - Fax:678-402-6594
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0041371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical