Provider Demographics
NPI:1780263533
Name:MILLER, HOLLY DELITE (PHD, NCC, LCMHCA)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:DELITE
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHD, NCC, LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 W CHARLESTON AVE
Mailing Address - Street 2:
Mailing Address - City:SWANNANOA
Mailing Address - State:NC
Mailing Address - Zip Code:28778-2555
Mailing Address - Country:US
Mailing Address - Phone:828-490-5516
Mailing Address - Fax:
Practice Address - Street 1:209 W CHARLESTON AVE
Practice Address - Street 2:
Practice Address - City:SWANNANOA
Practice Address - State:NC
Practice Address - Zip Code:28778-2555
Practice Address - Country:US
Practice Address - Phone:828-490-5516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16444101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty