Provider Demographics
NPI:1689410110
Name:MILLER, SEVONTE H (LCSW)
Entity type:Individual
Prefix:
First Name:SEVONTE
Middle Name:H
Last Name:MILLER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 SE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-4540
Mailing Address - Country:US
Mailing Address - Phone:561-266-8866
Mailing Address - Fax:561-404-4735
Practice Address - Street 1:403 SE 1ST ST
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-4540
Practice Address - Country:US
Practice Address - Phone:561-266-8866
Practice Address - Fax:561-404-4735
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW230971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical