Individual
GENE S MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, LMFT
Contact information
Practice address
102 HERITAGE WAY NE STE 302, LEESBURG, VA 20176-4544
(703) 771-5100
(703) 777-0170
Mailing address
102 HERITAGE WAY NE STE 302, LEESBURG, VA 20176-4544
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701002291
VA
106H00000X
Marriage & Family Therapist
0717000069
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209313
ANTHEM
VA
01
—
209314
ANTHEM
VA
01
—
293483
AMERIGROUP
VA
Enumeration date
08/29/2006
Last updated
09/06/2007
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