| Miles Psychological Services, Llc | |
|
606 25th Ave S Suite 105 Saint Cloud MN 56301-4810 | |
| (320) 247-4737 | |
| (320) 365-0080 |
| Full Name | Miles Psychological Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 606 25th Ave S, Saint Cloud, Minnesota |
| Authorized Official Name and Position | Vincent Miles (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 13202474737 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miles Psychological Services, Llc 606 25th Ave S Suite 105 Saint Cloud MN 56301-4810 Ph: (320) 247-4737 | Miles Psychological Services, Llc 606 25th Ave S Suite 105 Saint Cloud MN 56301-4810 Ph: (320) 247-4737 |
| NPI Number | 1548637507 |
|---|---|
| Provider Enumeration Date | 08/26/2015 |
| Last Update Date | 08/26/2015 |
| Medicare PECOS PAC ID | 4082920368 |
|---|---|
| Medicare Enrollment ID | O20150901002002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548637507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | LP5676 (Minnesota) | Primary |
| Provider Name | Vincent D Miles |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912255449 PECOS PAC ID: 3577790013 Enrollment ID: I20131209000746 |
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