Provider Demographics
NPI:1689003022
Name:MILLER, TAMMY SPEARS (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:SPEARS
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 1:100 PROFESSIONAL CT
Mailing Address - Street 2:#104
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-7971
Mailing Address - Country:US
Mailing Address - Phone:919-706-5004
Mailing Address - Fax:910-706-5631
Practice Address - Street 1:100 PROFESSIONAL CT
Practice Address - Street 2:#104
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-7971
Practice Address - Country:US
Practice Address - Phone:919-706-5004
Practice Address - Fax:919-706-5631
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0086011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical