Provider Demographics
NPI:1235848680
Name:MILLER, ABIGAIL H (LCSW-C)
Entity Type:Individual
Prefix:
First Name:ABIGAIL H
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6508 BANBURY RD
Mailing Address - Street 2:
Mailing Address - City:IDLEWYLDE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-1343
Mailing Address - Country:US
Mailing Address - Phone:410-913-0432
Mailing Address - Fax:
Practice Address - Street 1:6508 BANBURY RD
Practice Address - Street 2:
Practice Address - City:IDLEWYLDE
Practice Address - State:MD
Practice Address - Zip Code:21239-1343
Practice Address - Country:US
Practice Address - Phone:410-913-0432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD243641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical