Provider Demographics
NPI:1740226059
Name:MILLER, STANLEY H (LPC)
Entity Type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:H
Last Name:MILLER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-3523
Mailing Address - Country:US
Mailing Address - Phone:970-241-2948
Mailing Address - Fax:970-242-4219
Practice Address - Street 1:1170 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-3523
Practice Address - Country:US
Practice Address - Phone:970-241-2948
Practice Address - Fax:970-242-4219
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional