| Miles Counseling Llc | |
|
518 Willard Ave Pocatello ID 83201-4537 | |
| (208) 339-6565 | |
| Not Available |
| Full Name | Miles Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 518 Willard Ave, Pocatello, Idaho |
| Authorized Official Name and Position | Jennifer M Miles (OWNER) |
| Authorized Official Contact | 2083396565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miles Counseling Llc 518 Willard Ave Pocatello ID 83201-4537 Ph: (208) 339-6565 | Miles Counseling Llc 518 Willard Ave Pocatello ID 83201-4537 Ph: (208) 339-6565 |
| NPI Number | 1811762875 |
|---|---|
| Provider Enumeration Date | 11/20/2023 |
| Last Update Date | 11/20/2023 |
| Certification Date | 11/20/2023 |
| Medicare PECOS PAC ID | 4587014535 |
|---|---|
| Medicare Enrollment ID | O20240103001427 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811762875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jennifer Marie Miles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083017578 PECOS PAC ID: 3577826692 Enrollment ID: I20180424000616 |
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