Provider Demographics
NPI:1144485194
Name:MILLER, VICTORIA JOLENE (LPC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:JOLENE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2521 E. MTN VILLAGE DR.
Mailing Address - Street 2:STE B PMB 287
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7989
Mailing Address - Country:US
Mailing Address - Phone:866-210-8282
Mailing Address - Fax:
Practice Address - Street 1:401 W FALLEN LEAF CIR
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7989
Practice Address - Country:US
Practice Address - Phone:866-210-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1020986Medicaid