Provider Demographics
NPI:1821112434
Name:MILLER, ROBERT A (LPC, MA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:MILLER
Suffix:
Gender:M
Credentials:LPC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 MAIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-2848
Mailing Address - Country:US
Mailing Address - Phone:715-343-5256
Mailing Address - Fax:715-343-5899
Practice Address - Street 1:1052 MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-2848
Practice Address - Country:US
Practice Address - Phone:715-343-5256
Practice Address - Fax:715-343-5899
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15193101YA0400X
WI3254-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health