Provider Demographics
NPI:1720258783
Name:MILLER, LAURA A (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 NAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12786
Mailing Address - Country:US
Mailing Address - Phone:845-583-7138
Mailing Address - Fax:
Practice Address - Street 1:68 HARRIS BUSHVILLE RD
Practice Address - Street 2:
Practice Address - City:HARRIS
Practice Address - State:NY
Practice Address - Zip Code:12742
Practice Address - Country:US
Practice Address - Phone:845-794-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076157282NR1301X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No282NR1301XHospitalsGeneral Acute Care HospitalRural