Provider Demographics
NPI:1013176460
Name:CLASSEN-MILLER & ASSOCIATES LLC
Entity Type:Organization
Organization Name:CLASSEN-MILLER & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW-C
Authorized Official - Prefix:MS
Authorized Official - First Name:GERTRUD
Authorized Official - Middle Name:IRMGARD
Authorized Official - Last Name:CLASSEN-MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-977-0824
Mailing Address - Street 1:13111 MORAN CT
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3922
Mailing Address - Country:US
Mailing Address - Phone:301-977-0824
Mailing Address - Fax:
Practice Address - Street 1:13111 MORAN CT
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-3922
Practice Address - Country:US
Practice Address - Phone:301-977-0824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD071971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD491403Medicare UPIN