Provider Demographics
NPI:1841587607
Name:MILLER, CLAUDINE (LPC, CRAADC, CCDP-D)
Entity Type:Individual
Prefix:
First Name:CLAUDINE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPC, CRAADC, CCDP-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3834 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63116-4841
Mailing Address - Country:US
Mailing Address - Phone:314-780-8328
Mailing Address - Fax:
Practice Address - Street 1:12166 OLD BIG BEND RD STE 210
Practice Address - Street 2:
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-6836
Practice Address - Country:US
Practice Address - Phone:314-780-8328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010019253101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional