Provider Demographics
NPI:1831366004
Name:MILLER PSYCHOLOGICAL ASSOCIATES LLC
Entity type:Organization
Organization Name:MILLER PSYCHOLOGICAL ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUE
Authorized Official - Middle Name:BARRICK
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:770-833-9966
Mailing Address - Street 1:6740 JAMESTOWN DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-3030
Mailing Address - Country:US
Mailing Address - Phone:770-833-9966
Mailing Address - Fax:678-513-0743
Practice Address - Street 1:6740 JAMESTOWN DR
Practice Address - Street 2:SUITE 301
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-3030
Practice Address - Country:US
Practice Address - Phone:404-217-5792
Practice Address - Fax:678-513-0743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1336470780OtherKAREN TANTILLO LCSW
GA1043327612OtherDR. SUE MILLER
GA1932312774OtherSTACEY J. NYMAN, MS, NCC, LAPC