Provider Demographics
NPI:1528436250
Name:MILLER, JILL H (LPC)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:H
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 1:4221 W LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:PARKESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:19365-1780
Mailing Address - Country:US
Mailing Address - Phone:610-563-4112
Mailing Address - Fax:
Practice Address - Street 1:4221 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:PARKESBURG
Practice Address - State:PA
Practice Address - Zip Code:19365-1780
Practice Address - Country:US
Practice Address - Phone:610-563-4112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005618101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1154624252OtherORGANIZATIONAL NPI