Provider Demographics
NPI:1831940097
Name:MILLER, SHANICE (LCSWA)
Entity type:Individual
Prefix:
First Name:SHANICE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 BATTLEGROUND AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2490
Mailing Address - Country:US
Mailing Address - Phone:336-285-7173
Mailing Address - Fax:336-285-7174
Practice Address - Street 1:3300 BATTLEGROUND AVE STE 204
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2490
Practice Address - Country:US
Practice Address - Phone:336-285-7173
Practice Address - Fax:336-285-7174
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical