Provider Demographics
NPI:1629303854
Name:MILLER, ABIGAIL J (LCSW)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:J
Last Name: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 1:205 GLENBROOK RD
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-1305
Mailing Address - Country:US
Mailing Address - Phone:845-548-0698
Mailing Address - Fax:
Practice Address - Street 1:205 GLENBROOK RD
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-1305
Practice Address - Country:US
Practice Address - Phone:845-548-0698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR021351-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical