Provider Demographics
NPI:1609407972
Name:MILLER LEWIS, LAURA D (LCSW-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:D
Last Name:MILLER LEWIS
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 1:12614 BEDFORD RD NE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-6850
Mailing Address - Country:US
Mailing Address - Phone:301-707-8696
Mailing Address - Fax:
Practice Address - Street 1:300 E OLDTOWN RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-3600
Practice Address - Country:US
Practice Address - Phone:301-707-8696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-27
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD172731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical