Provider Demographics
NPI:1881624740
Name:MILLER, NAN (LCSW, PHD)
Entity type:Individual
Prefix:DR
First Name:NAN
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3030
Mailing Address - Country:US
Mailing Address - Phone:914-273-3251
Mailing Address - Fax:
Practice Address - Street 1:275 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3030
Practice Address - Country:US
Practice Address - Phone:914-273-3251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR003358-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0004242219OtherAETNA PIN
NY0073121OtherGHI
NYNO4991Medicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER