Provider Demographics
NPI:1922046796
Name:MILLER, JUDITH MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:MARIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:MARIE
Other - Last Name:MILAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1605 N CEDAR CREST BLVD STE 411
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2323
Mailing Address - Country:US
Mailing Address - Phone:610-969-1914
Mailing Address - Fax:610-969-3951
Practice Address - Street 1:1259 S CEDAR CREST BLVD STE 230
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6376
Practice Address - Country:US
Practice Address - Phone:610-402-5900
Practice Address - Fax:610-402-4650
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0153041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical