Provider Demographics
NPI:1639133937
Name:AKINS, MIRIAM F (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:F
Last Name:AKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:MIRIAM
Other - Middle Name:MOORE
Other - Last Name:FARMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BFA
Mailing Address - Street 1:325 EAST 80TH ST.
Mailing Address - Street 2:#1C
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0645
Mailing Address - Country:US
Mailing Address - Phone:212-744-9793
Mailing Address - Fax:646-755-8531
Practice Address - Street 1:325 EAST 80TH ST
Practice Address - Street 2:#1C
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10075-0645
Practice Address - Country:US
Practice Address - Phone:212-744-9793
Practice Address - Fax:646-755-8531
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0257481041C0700X
NYR025748-LCSW104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY071584020OtherUNITED BEHAVIORAL HEALTH
NYN42301Medicaid
NYN42301Medicaid
NYN42301Medicare UPIN