Provider Demographics
NPI:1326455148
Name:MILLER, DANA RIBEIRO (MDIV, LCSW, APHSW-C)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:RIBEIRO
Last Name:MILLER
Suffix:
Gender:F
Credentials:MDIV, LCSW, APHSW-C
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:MARIE
Other - Last Name:RIBEIRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MDIV, LMSW
Mailing Address - Street 1:52 ALBERMARLE AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-2025
Mailing Address - Country:US
Mailing Address - Phone:973-294-4646
Mailing Address - Fax:
Practice Address - Street 1:52 ALBERMARLE AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-2025
Practice Address - Country:US
Practice Address - Phone:973-294-4646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY089277104100000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health