Provider Demographics
NPI:1902539901
Name:MILLER, CARRIE (SWLC)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:SWLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 MENLO PARK RD
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-8100
Mailing Address - Country:US
Mailing Address - Phone:406-422-8711
Mailing Address - Fax:
Practice Address - Street 1:3404 COONEY DR STE 108
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-0215
Practice Address - Country:US
Practice Address - Phone:406-952-3772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-SWLC-LIC-568381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical