Provider Demographics
NPI:1770597205
Name:MILLER, RHODA K (LCSW, PMHCNS-BC)
Entity type:Individual
Prefix:MS
First Name:RHODA
Middle Name:K
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW, PMHCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 APPLETHORN DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-2180
Mailing Address - Country:US
Mailing Address - Phone:919-267-4529
Mailing Address - Fax:919-267-4529
Practice Address - Street 1:1012 APPLETHORN DR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-2180
Practice Address - Country:US
Practice Address - Phone:919-267-4529
Practice Address - Fax:919-267-4529
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCOO24871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COO2487OtherLSCW
NC6106858Medicaid