Provider Demographics
NPI:1689071953
Name:MILTON, ALTHEA P
Entity Type:Individual
Prefix:MS
First Name:ALTHEA
Middle Name:P
Last Name:MILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ALTHEA
Other - Middle Name:P
Other - Last Name:MILTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:15 OAK CREST DRIVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528
Mailing Address - Country:US
Mailing Address - Phone:845-656-7897
Mailing Address - Fax:
Practice Address - Street 1:15 OAK CREST DRIVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528
Practice Address - Country:US
Practice Address - Phone:845-656-7897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0808681041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool