Provider Demographics
NPI:1780331306
Name:MILLER, CARRIE ROSE (LSCSW)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ROSE
Last Name:MILLER
Suffix:
Gender:
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 SW TOPEKA BLVD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66612-1815
Mailing Address - Country:US
Mailing Address - Phone:785-259-2559
Mailing Address - Fax:
Practice Address - Street 1:1260 SW TOPEKA BLVD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66612-1815
Practice Address - Country:US
Practice Address - Phone:785-259-2559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-03
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11741104100000X
KS059311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker