Provider Demographics
NPI:1821530692
Name:MILLER, CAROL (PHD, LPC, LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHD, LPC, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 613
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05773-0613
Mailing Address - Country:US
Mailing Address - Phone:802-755-5701
Mailing Address - Fax:
Practice Address - Street 1:214 N END RD
Practice Address - Street 2:
Practice Address - City:TINMOUTH
Practice Address - State:VT
Practice Address - Zip Code:05773-1172
Practice Address - Country:US
Practice Address - Phone:802-755-8701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-10
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0134460101YM0800X
NY2103867UPD101YM0800X
MO2014038424101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health