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NPI Code Detail

MEDICARE: MAXX MILLER LMSW

MEDICARE: MAXX MILLER LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346798212
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAXX MILLER LMSW
Provider Business Mailing Address
First Line : PO BOX 1188
Second Line :
City : ALBANY
State : NY
Zip : 12201-1188
Country : US
Telephone Number : 518-952-8140
Fax Number : 518-952-8287
Provider Business Practice Location Address
First Line : 8002 KEW GARDENS RD STE 704
Second Line :
City : KEW GARDENS
State : NY
Zip : 11415-3607
Country : US
Telephone Number : 718-520-1513
Fax Number : 718-520-6460
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2016
Last Update Date : 11/23/2016

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