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MRS. TERESA KAY MILLER MSW, LCSW

Clinical >> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1104860238

Individual Registrant:
MRS. TERESA KAY MILLER MSW, LCSW
Gender: F
Sole Proprietor

Location and contact information for practice:
205 S SILAS AVE  MC LEANSBORO, IL 62859-1135 US
Tel: 618-237-2906  Fax: 618-643-3128

Contact information for business:
RR 1 BOX 284A  MC LEANSBORO, IL 62859-9785 US
Tel: 618-237-2906  Fax: 618-643-3128

Registration Information:
NPI: 1104860238
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
Clinical
IL149005459
N1041S0200XBehavioral Health & Social Service Providers
Social Worker
IL1377075

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BLUE CROSS NUMBER03332001IL01
TRI-CARE NUMBER371358897IL01




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