Provider Demographics
NPI:1851808364
Name:MILLER, SALLY BARBARA (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:SALLY
Middle Name:BARBARA
Last Name:MILLER
Suffix:
Gender:F
Credentials:LICSW
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Other - Credentials:
Mailing Address - Street 1:50 CABOT STREET SUITE 206
Mailing Address - Street 2:PLAN OF MASSACHUSETTS AND RHODE ISLAND
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494
Mailing Address - Country:US
Mailing Address - Phone:617-244-5552
Mailing Address - Fax:617-795-0559
Practice Address - Street 1:50 CABOT STREET SUITE 206
Practice Address - Street 2:PLAN OF MASSACHUSETTS AND RHODE ISLAND
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494
Practice Address - Country:US
Practice Address - Phone:617-244-5552
Practice Address - Fax:617-795-0559
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1014671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical