Basic Information
Provider Information
NPI: 1417229550
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILLER
FirstName: CHRISTOPHER
MiddleName: P
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 620 COURT ST
Address2: FIFITH FLOOR
City: LYNCHBURG
State: VA
PostalCode: 245041312
CountryCode: US
TelephoneNumber: 4344858861
FaxNumber: 4344858877
Practice Location
Address1: 620 COURT ST
Address2: FIFITH FLOOR
City: LYNCHBURG
State: VA
PostalCode: 245041312
CountryCode: US
TelephoneNumber: 4344858861
FaxNumber: 4344858877
Other Information
ProviderEnumerationDate: 02/06/2012
LastUpdateDate: 02/13/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X0701005183VAY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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