Provider Demographics
NPI:1144383282
Name:MILLER, THOMAS EDWARD (LMSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:EDWARD
Last Name:MILLER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 WEST ST
Mailing Address - Street 2:APT. 2
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3137
Mailing Address - Country:US
Mailing Address - Phone:914-835-0454
Mailing Address - Fax:
Practice Address - Street 1:103 WEST ST
Practice Address - Street 2:APT. 2
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3137
Practice Address - Country:US
Practice Address - Phone:914-835-0454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY06111111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical