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Individual

MR. JEREMY KEITH MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, LISW-S,LICDC-CS

Contact information

Practice address
3401 GLENDALE AVE STE 200, TOLEDO, OH 43614-2490
(567) 742-7117
(567) 200-8410
Mailing address
3401 GLENDALE AVE STE 200, TOLEDO, OH 43614-2490
(567) 218-1980

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.161437
OH
1041C0700X
Clinical Social Worker
Primary
I.1700237-SUPV
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0231357
OH
Enumeration date
08/06/2015
Last updated
04/29/2026
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