Provider Demographics
NPI:1750059283
Name:MILLER THERAPEUTIC SERVICES LLC
Entity type:Organization
Organization Name:MILLER THERAPEUTIC SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-610-9786
Mailing Address - Street 1:10339 SOUTHERN MARYLAND BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-3018
Mailing Address - Country:US
Mailing Address - Phone:301-327-5417
Mailing Address - Fax:
Practice Address - Street 1:10339 SOUTHERN MARYLAND BLVD STE 211
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-3018
Practice Address - Country:US
Practice Address - Phone:301-327-5417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-31
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD69032OtherJHH
MD69032OtherOPTUM
MDE599169Medicaid
MD3663834OtherCIGNA
MD75300049OtherBCBS