Provider Demographics
NPI:1689727877
Name:MILLER, KAREN (SWA,LCDCII)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:SWA,LCDCII
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:CARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SWA,LCDCII
Mailing Address - Street 1:107 OREGONIA RD FL 2
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-3903
Mailing Address - Country:US
Mailing Address - Phone:513-695-2411
Mailing Address - Fax:513-695-2309
Practice Address - Street 1:212 COOK RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-9600
Practice Address - Country:US
Practice Address - Phone:513-695-1354
Practice Address - Fax:513-695-1831
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHW-1101591041C0700X
OH9762471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical