Provider Demographics
NPI:1629966288
Name:MILLIEN-WEBSTER, MARIE JILLIAN
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:JILLIAN
Last Name:MILLIEN-WEBSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 WINDSOR WAY
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-7106
Mailing Address - Country:US
Mailing Address - Phone:570-982-9099
Mailing Address - Fax:
Practice Address - Street 1:306 WINDSOR WAY
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-7106
Practice Address - Country:US
Practice Address - Phone:570-982-9099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH005225101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional