Provider Demographics
NPI:1831150481
Name:MILLER, DARRELL P (LSCSW BCD)
Entity type:Individual
Prefix:MR
First Name:DARRELL
Middle Name:P
Last Name:MILLER
Suffix:
Gender:M
Credentials:LSCSW BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 S WINDSOR RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-4956
Mailing Address - Country:US
Mailing Address - Phone:913-764-7943
Mailing Address - Fax:
Practice Address - Street 1:810 W 110TH ST
Practice Address - Street 2:SUITE 510
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211
Practice Address - Country:US
Practice Address - Phone:913-491-3460
Practice Address - Fax:913-491-1141
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS614101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS614OtherSTATE LICENSE