Provider Demographics
NPI:1912211871
Name:MILLER PSYCHOLOGICAL AND FAMILY SERVICE, INC
Entity Type:Organization
Organization Name:MILLER PSYCHOLOGICAL AND FAMILY SERVICE, INC
Other - Org Name:SYNC COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD DMIN
Authorized Official - Phone:626-802-5493
Mailing Address - Street 1:482 N ROSEMEAD BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3000
Mailing Address - Country:US
Mailing Address - Phone:626-802-5493
Mailing Address - Fax:626-466-1199
Practice Address - Street 1:482 N ROSEMEAD BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3000
Practice Address - Country:US
Practice Address - Phone:626-802-5493
Practice Address - Fax:626-466-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-03
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 31636251S00000X, 273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No273R00000XHospital UnitsPsychiatric Unit