Provider Demographics
NPI:1952551343
Name:MILLER, CHADRICK EARL (LMSW)
Entity Type:Individual
Prefix:MR
First Name:CHADRICK
Middle Name:EARL
Last Name:MILLER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 W 43RD AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66103-3125
Mailing Address - Country:US
Mailing Address - Phone:913-708-8247
Mailing Address - Fax:
Practice Address - Street 1:2708 W 43RD AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66103-3125
Practice Address - Country:US
Practice Address - Phone:913-708-8247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMSW72621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical