Provider Demographics
NPI:1871846139
Name:MCMILLAN, SARAH (MFT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:SIMONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:151 BURRS LN
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6052
Mailing Address - Country:US
Mailing Address - Phone:631-253-3480
Mailing Address - Fax:631-253-3483
Practice Address - Street 1:151 BURRS LN
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-6052
Practice Address - Country:US
Practice Address - Phone:631-253-3480
Practice Address - Fax:631-253-3483
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP86084106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist