Healthcare Provider Details

I. General information

NPI: 1306730551
Provider Name (Legal Business Name): CARRIE ANNE MILHAM LICENSED CLINICAL SOCIAL WORKER P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 06/04/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 ROUTE 146
CLIFTON PARK NY
12065-3644
US

IV. Provider business mailing address

1023 ROUTE 146
CLIFTON PARK NY
12065-3644
US

V. Phone/Fax

Practice location:
  • Phone: 518-810-7028
  • Fax: 518-750-0583
Mailing address:
  • Phone: 518-810-7028
  • Fax: 518-750-0583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. CARRIE ANNE N MILHAM
Title or Position: OWNER
Credential: LCSW
Phone: 518-810-7028