Provider Demographics
NPI:1023657160
Name:MILLER, MICHAEL A (LPCC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:MILLER
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3373 E MONMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-4239
Mailing Address - Country:US
Mailing Address - Phone:216-505-0106
Mailing Address - Fax:216-504-9669
Practice Address - Street 1:8500 STATION ST STE 102
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-4968
Practice Address - Country:US
Practice Address - Phone:440-591-4366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2404523101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health