Provider Demographics
NPI:1669538427
Name:MILLER, JULIE W, (LCSW, LCAT, ADTR)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:W,
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW, LCAT, ADTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 PARKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1499
Mailing Address - Country:US
Mailing Address - Phone:718-284-2564
Mailing Address - Fax:
Practice Address - Street 1:359 PARKSIDE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-1499
Practice Address - Country:US
Practice Address - Phone:347-247-8184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR030372-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist