Provider Demographics
NPI:1669594529
Name:MILLER, BARBARA E (MSW LICSW)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:E
Last Name:MILLER
Suffix:
Gender:F
Credentials:MSW LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 MARGARETTA DRIVE
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-1042
Mailing Address - Country:US
Mailing Address - Phone:617-364-2358
Mailing Address - Fax:
Practice Address - Street 1:22 SPEAR STREET
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4514
Practice Address - Country:US
Practice Address - Phone:617-773-4100
Practice Address - Fax:617-847-4450
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1057391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000PP0112OtherBCBS
0000PP0112OtherBCBS
P03645Medicare ID - Type Unspecified