Provider Demographics
NPI:1831263805
Name:MILLER, KAREN (LCSW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10901 WINNER ROAD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64052-0169
Mailing Address - Country:US
Mailing Address - Phone:816-254-3652
Mailing Address - Fax:816-254-9243
Practice Address - Street 1:10901 WINNER ROAD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64052-0169
Practice Address - Country:US
Practice Address - Phone:816-254-3652
Practice Address - Fax:816-254-9243
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
005245101YA0400X
MO0052451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical