Provider Demographics
NPI:1659760429
Name:LMSW FAMILY & INDIVIDUAL COUNSELING PLLC
Entity Type:Organization
Organization Name:LMSW FAMILY & INDIVIDUAL COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ATHENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILONAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:845-398-0399
Mailing Address - Street 1:321 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TAPPAN
Mailing Address - State:NY
Mailing Address - Zip Code:10983-2615
Mailing Address - Country:US
Mailing Address - Phone:845-398-0399
Mailing Address - Fax:
Practice Address - Street 1:321 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TAPPAN
Practice Address - State:NY
Practice Address - Zip Code:10983-2615
Practice Address - Country:US
Practice Address - Phone:845-398-0399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-16
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078214-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty