Provider Demographics
NPI:1881205250
Name:MILLER, JANIS CARYN (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JANIS
Middle Name:CARYN
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 ELKRIDGE LANDING RD STE 350
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2909
Mailing Address - Country:US
Mailing Address - Phone:443-354-8903
Mailing Address - Fax:443-410-0463
Practice Address - Street 1:939 ELKRIDGE LANDING RD STE 350
Practice Address - Street 2:
Practice Address - City:LINTHICUM
Practice Address - State:MD
Practice Address - Zip Code:21090-2909
Practice Address - Country:US
Practice Address - Phone:443-354-8903
Practice Address - Fax:443-410-0463
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD066891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical