Provider Demographics
NPI:1972058147
Name:MILLER, CAROL J (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:J
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-2508
Mailing Address - Country:US
Mailing Address - Phone:216-361-4400
Mailing Address - Fax:216-361-2340
Practice Address - Street 1:3134 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-2508
Practice Address - Country:US
Practice Address - Phone:216-361-2441
Practice Address - Fax:216-361-2340
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.00700066101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health