Provider Demographics
NPI:1053018598
Name:MILLER, ERICA MAE (LLPC)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:MAE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8318 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:GAINES
Mailing Address - State:MI
Mailing Address - Zip Code:48436-9732
Mailing Address - Country:US
Mailing Address - Phone:586-212-0349
Mailing Address - Fax:
Practice Address - Street 1:8245 HOLLY RD STE 200
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-2483
Practice Address - Country:US
Practice Address - Phone:586-212-0349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451006778101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor