Provider Demographics
NPI:1881316370
Name:MILLER, JENNIFER MORGAN (MHC-LP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MORGAN
Last Name:MILLER
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MORGAN
Other - Last Name:COTTET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHC-LP
Mailing Address - Street 1:11 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-3968
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-3968
Practice Address - Country:US
Practice Address - Phone:518-725-4310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004118101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty