Provider Demographics
NPI:1003474537
Name:MILES COUNSELING SERVICES
Entity Type:Organization
Organization Name:MILES COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:IMAN-MILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-452-2025
Mailing Address - Street 1:18 N 200 E STE 311
Mailing Address - Street 2:
Mailing Address - City:TREMONTON
Mailing Address - State:UT
Mailing Address - Zip Code:84337-1406
Mailing Address - Country:US
Mailing Address - Phone:435-452-2025
Mailing Address - Fax:888-977-1509
Practice Address - Street 1:18 N 200 E STE 311
Practice Address - Street 2:
Practice Address - City:TREMONTON
Practice Address - State:UT
Practice Address - Zip Code:84337-1406
Practice Address - Country:US
Practice Address - Phone:435-452-2025
Practice Address - Fax:888-977-1509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty