Provider Demographics
NPI:1548480940
Name:MILLER, CHERYL (LMHP, LMSW)
Entity type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMHP, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 VAN DORN STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-2507
Mailing Address - Country:US
Mailing Address - Phone:402-434-2550
Mailing Address - Fax:402-434-2358
Practice Address - Street 1:4701 VAN DORN STREET
Practice Address - Street 2:SUITE A
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2507
Practice Address - Country:US
Practice Address - Phone:402-434-2550
Practice Address - Fax:402-434-2358
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2293101Y00000X
NE10171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470679284-13Medicaid
NENA1909001OtherMEDICARE PTAN