Provider Demographics
NPI:1245253558
Name:MILLER, VICTORIA E (LCSW)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:E
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 MAIN ST
Mailing Address - Street 2:STE 7A
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-2503
Mailing Address - Country:US
Mailing Address - Phone:850-863-2873
Mailing Address - Fax:850-689-8799
Practice Address - Street 1:225 MAIN ST STE 7A
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-2550
Practice Address - Country:US
Practice Address - Phone:850-404-2294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 64161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical