Individual
MAXX MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
8002 KEW GARDENS RD STE 704, KEW GARDENS, NY 11415-3607
(718) 520-1513
(718) 520-6460
Mailing address
PO BOX 1188, ALBANY, NY 12201-1188
(518) 952-8140
(518) 952-8287
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420795
—
NY
Enumeration date
09/20/2016
Last updated
11/23/2016
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