Provider Demographics
NPI:1740838614
Name:MILLER, JENNIFER (LCPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MILLER
Suffix:
Gender:
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 N MONTANA ST
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:MT
Mailing Address - Zip Code:59725-3300
Mailing Address - Country:US
Mailing Address - Phone:406-925-3146
Mailing Address - Fax:406-988-0060
Practice Address - Street 1:411 N MONTANA ST
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725-3300
Practice Address - Country:US
Practice Address - Phone:406-925-3146
Practice Address - Fax:406-988-0060
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-PCLC-LIC-37911101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health