Provider Demographics
NPI:1376987081
Name:MILKS-HINES, MARIANNE E (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:E
Last Name:MILKS-HINES
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 1:500 CENTRAL AVE
Mailing Address - Street 2:EQUINOX
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-2213
Mailing Address - Country:US
Mailing Address - Phone:518-435-9931
Mailing Address - Fax:518-459-3715
Practice Address - Street 1:500 CENTRAL AVE
Practice Address - Street 2:EQUINOX
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-2213
Practice Address - Country:US
Practice Address - Phone:518-435-9931
Practice Address - Fax:518-459-3715
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0768911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY076891OtherNEW YORK STATE