Provider Demographics
NPI:1760093934
Name:MILLER, CAITLIN RUBY (LPC)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:RUBY
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 SKOKIE BLVD UNIT 237
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4150
Mailing Address - Country:US
Mailing Address - Phone:608-284-0524
Mailing Address - Fax:
Practice Address - Street 1:1340 SHERMER RD STE 280
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4589
Practice Address - Country:US
Practice Address - Phone:608-284-0524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.015560101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional