Provider Demographics
NPI:1720850787
Name:MILLER, BETH LYSSA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:LYSSA
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 DEEPWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-2415
Mailing Address - Country:US
Mailing Address - Phone:914-523-1983
Mailing Address - Fax:
Practice Address - Street 1:1 CHASE RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4156
Practice Address - Country:US
Practice Address - Phone:914-523-1983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9254104100000X
NY051433104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker