Miller, Beryl M

Miller, Beryl M is an sole proprietor health care provider with primary practice located at 3424 Table Rock Dr , Gastonia NC 28052-5436. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Miller, Beryl M can be contacted via phone (704) 517-4527.

Contact Information

Primary practice address
3424 Table Rock Dr Gastonia NC 28052-5436
Phone: (704) 517-4527
Fax: (704) 372-2309
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X C003740 North Carolina

Profile Details

NPI number 1154488948
LBN Legal business name Miller, Beryl M
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 2nd, 2007
Last updated Dec 7th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154488948 NPPES
North Carolina Other 139HN NC HEALTH CHOICE
North Carolina MEDICAID 6002607 NC HEALTH CHOICE

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