Provider Demographics
NPI:1639426307
Name:MILLER, SCOTT THOMAS (CA LMFT 129223)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:THOMAS
Last Name:MILLER
Suffix:
Gender:M
Credentials:CA LMFT 129223
Other - Prefix:
Other - First Name:SCOTT
Other - Middle Name:THOMAS
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:HI MFT-876-0
Mailing Address - Street 1:2730 SHADELANDS DR BLDG 10
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2538
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5601 ARNOLD RD STE 160
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-7724
Practice Address - Country:US
Practice Address - Phone:925-248-9925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2024-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI876-0106H00000X
CA103477106H00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health