MEDICARE: MS. ANITA MILHAM LMHC

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
1	251S00000X	Community/Behavioral Health Agency	MHC00614	RI
2	251S00000X	Community/Behavioral Health Agency	8251	MA

General Provider Information

NPI Number	:	1447562350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANITA MILHAM LMHC

Provider Business Mailing Address
First Line	:	200 MAIN ST
Second Line	:	STE 210
City	:	PAWTUCKET
State	:	RI
Zip	:	02860-4131
Country	:	US
Telephone Number	:	401-728-1800
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 MAIN ST
Second Line	:	STE 210
City	:	PAWTUCKET
State	:	RI
Zip	:	02860-4131
Country	:	US
Telephone Number	:	401-728-1800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2010
Last Update Date	:	04/09/2014

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