Provider Demographics
NPI:1932731635
Name:MILLER, DAVID C (LMHC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:MILLER
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 CHESTNUT ST STE 2A
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-3600
Mailing Address - Country:US
Mailing Address - Phone:978-470-0774
Mailing Address - Fax:
Practice Address - Street 1:26 CHESTNUT ST STE 2A
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3600
Practice Address - Country:US
Practice Address - Phone:978-470-0774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11642-MH-CC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health