Provider Demographics
NPI:1184141160
Name:MILLER, KEYADD (LCSWA)
Entity type:Individual
Prefix:
First Name:KEYADD
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:886 BRUNSWICK DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-5782
Mailing Address - Country:US
Mailing Address - Phone:803-370-5507
Mailing Address - Fax:704-709-8580
Practice Address - Street 1:233 S SHARON AMITY RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-2880
Practice Address - Country:US
Practice Address - Phone:980-613-8474
Practice Address - Fax:704-709-8580
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-29
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0213571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical