Provider Demographics
NPI:1003165861
Name:MORALES-MILLER, MASSIELLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MASSIELLE
Middle Name:
Last Name:MORALES-MILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 E 102ND ST STE 215
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-5615
Mailing Address - Country:US
Mailing Address - Phone:212-241-8462
Mailing Address - Fax:
Practice Address - Street 1:345 E 102ND ST STE 215
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-5615
Practice Address - Country:US
Practice Address - Phone:212-241-8462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2022-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0869711041C0700X
MA413486104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical