MARY ELLEN MILLER MS LPC LLC NPI 1518762756

NPI Information

NPI: 1518762756
Provider Name: MARY ELLEN MILLER, MS, LPC, LLC
Classification: Clinic/Center - 261QM0801X
Specialization: Mental Health (Including Community Mental Health Center)
Entity Type: Organization
Address: W10445 STATE ROAD 16 LOT 21
PORTAGE, WI
ZIP 53901
Phone: (608) 617-8419

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NPI Details

MARY ELLEN MILLER, MS, LPC, LLC is a mental health (including community mental health center) clinic center in Portage, WI. MARY ELLEN MILLER, MS, LPC, LLC NPI is 1518762756. The provider is registered as an organization entity type.

The provider's business location address is:

W10445 STATE ROAD 16 LOT 21
PORTAGE, WI
ZIP 53901-488
Phone: (608) 617-8419

The provider's authorized official is Mary Ellen Ellen Miller Ms Miller .
The authorized official title is Director and has the following contact phone number (608) 617-8419.

The enumeration date for this NPI number is 2/13/2025 and was last updated on 2/13/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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