Provider Demographics
NPI:1881809440
Name:MILLER, DAVID DUANE (LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:DUANE
Last Name:MILLER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 CUMBERLAND ST
Mailing Address - Street 2:4TH FLOOR EXECUTIVE PLAZA
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24201-4324
Mailing Address - Country:US
Mailing Address - Phone:276-645-4758
Mailing Address - Fax:276-669-9093
Practice Address - Street 1:432 E MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-3488
Practice Address - Country:US
Practice Address - Phone:276-676-2908
Practice Address - Fax:276-669-9093
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040064971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical