Provider Demographics
NPI:1942953443
Name:MILANO, SAMANTHA R (MHC-LP, CASAC 2)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:R
Last Name:MILANO
Suffix:
Gender:F
Credentials:MHC-LP, CASAC 2
Other - Prefix:MRS
Other - First Name:SAMANTHA
Other - Middle Name:R
Other - Last Name:MEEHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MHC-LP, CASAC 2
Mailing Address - Street 1:11 FARBER DR
Mailing Address - Street 2:
Mailing Address - City:BELLPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11713-1500
Mailing Address - Country:US
Mailing Address - Phone:631-286-0700
Mailing Address - Fax:631-286-0688
Practice Address - Street 1:11 FARBER DR
Practice Address - Street 2:
Practice Address - City:BELLPORT
Practice Address - State:NY
Practice Address - Zip Code:11713-1500
Practice Address - Country:US
Practice Address - Phone:631-286-0700
Practice Address - Fax:631-286-0688
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health