Provider Demographics
NPI:1053652149
Name:MILLER, JEFFREY LEE (MS, LCMC, LMHC, CAP)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:LEE
Last Name:MILLER
Suffix:
Gender:
Credentials:MS, LCMC, LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 BURKE CT APT 306
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-0479
Mailing Address - Country:US
Mailing Address - Phone:910-386-8848
Mailing Address - Fax:
Practice Address - Street 1:1241 COLUMBUS CIR APT A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403
Practice Address - Country:US
Practice Address - Phone:239-248-2734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 5430101YA0400X
NC14163101YP2500X
FLMH11687101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional