Individual
CHERYL MILLER-TIVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, MSSW
Contact information
Practice address
607 OLD HIGHWAY 60, HARDINSBURG, KY 40143-2511
(270) 756-5816
(270) 756-5815
Mailing address
107 CRANES ROOST CT, ELIZABETHTOWN, KY 42701-3650
(270) 765-2605
(270) 766-1222
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1165
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000044429
ANTHEM
KY
01
—
11490556
CAQH
—
01
—
233629
TRICARE
KY
05
—
30605018
—
KY
Enumeration date
05/24/2006
Last updated
10/30/2007
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