Provider Demographics
NPI:1679642391
Name:MILLER, WILLIAM J (LMSW)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:J
Last Name:MILLER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1081 DEVELOPMENT COURT
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401
Mailing Address - Country:US
Mailing Address - Phone:518-239-6666
Mailing Address - Fax:
Practice Address - Street 1:1081 DEVELOPMENT CT
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401
Practice Address - Country:US
Practice Address - Phone:845-334-5083
Practice Address - Fax:845-334-5090
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0626141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical