Provider Demographics
NPI: | 1245395367 |
---|---|
Name: | MILLER, ELLEN E (LPC LMFT NCDC) |
Entity type: | Individual |
Prefix: | MRS |
First Name: | ELLEN |
Middle Name: | E |
Last Name: | MILLER |
Suffix: | |
Gender: | F |
Credentials: | LPC LMFT NCDC |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 203 LAURENS ST SW |
Mailing Address - Street 2: | |
Mailing Address - City: | AIKEN |
Mailing Address - State: | SC |
Mailing Address - Zip Code: | 29801 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 803-643-0173 |
Mailing Address - Fax: | 803-649-3337 |
Practice Address - Street 1: | 203 LAURENS ST SW |
Practice Address - Street 2: | |
Practice Address - City: | AIKEN |
Practice Address - State: | SC |
Practice Address - Zip Code: | 29801 |
Practice Address - Country: | US |
Practice Address - Phone: | 803-643-0173 |
Practice Address - Fax: | 803-649-3337 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-12-27 |
Last Update Date: | 2025-09-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
SC | 0610276 | 101YA0400X |
SC | 2273 | 101YP2500X |
SC | 3941 | 106H00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional |
No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist |