Joseph Maylen Miller, MSW DCSW LSCSW

Individual provider Active NPI Clinical Social Worker · Coffeyville, KS

NPI 1154544708 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1154544708
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
0164 (KS)
Practice address
1411 W 4TH St
Family Consultation Services Ste C
Coffeyville, KS 67337-3300
Phone
(620) 251-6967
Fax
(620) 251-6967
NPI assigned
Apr 11, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0164KSMDClinical Social Worker
20704TXMDClinical Social Worker
1686OKMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0164 KS Yes
Clinical Social Worker 1041C0700X 1686 OK
Clinical Social Worker 1041C0700X 20704 TX

Addresses

Primary practice location

1411 W 4TH St
Family Consultation Services Ste C
Coffeyville, KS 67337-3300

Mailing address

1411 W 4TH St
Family Consultation Services Ste C
Coffeyville, KS 67337-3300
Phone (620) 251-6967

Other identifiers

IdentifierTypeStateIssuer
0000011148OtherKSBCBS

Other names

  • Mr. Joe M Miller Professional name

Other providers in Coffeyville, KS

All providers in Coffeyville, KS · Clinical Social Worker in Kansas

Sources for this page

Verify at the official NPI Registry.