Provider Demographics
NPI:1134340433
Name:MILLER, JEFFREY A (LCSW)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:A
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 1:9999 NE 2 AVE
Mailing Address - Street 2:STE 301
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2346
Mailing Address - Country:US
Mailing Address - Phone:786-218-7937
Mailing Address - Fax:305-758-6111
Practice Address - Street 1:9999 NE 2ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2352
Practice Address - Country:US
Practice Address - Phone:786-218-7937
Practice Address - Fax:305-758-6111
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW81551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical