Provider Demographics
NPI:1689711582
Name:MILLER, MONTY WAYNE (LSCSW)
Entity Type:Individual
Prefix:MR
First Name:MONTY
Middle Name:WAYNE
Last Name:MILLER
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 COLLEGE BLVD
Mailing Address - Street 2:STE. 260
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1844
Mailing Address - Country:US
Mailing Address - Phone:913-593-3032
Mailing Address - Fax:
Practice Address - Street 1:8400 W 110TH ST STE 250
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2461
Practice Address - Country:US
Practice Address - Phone:913-327-7505
Practice Address - Fax:913-327-7054
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS19931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical