Doctor Name: | MR. MICHAEL MILES |
NPI Number: | 1194709618 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 000534 |
Business Practice Address: | 100 S Prewitt St Nevada, MO - 647721760 |
Business Phone Number: | 4176678700 |
Business Fax Number: | 4176677382 |
Mailing Address: | 100 S Prewitt St, NEVADA |
State: | MO |
Postal Code: | 647721760 |
Phone Number: | 4176678700 |
Fax Number: | 4176677382 |
NPI Enumeration Date: | 11/30/2005 |
NPI Last Update Date: | 11/09/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 000534 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |