Provider Demographics
NPI:1508990904
Name:AILES, MICHAEL SCOT (MSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:SCOT
Last Name:AILES
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 STONEWAY LN
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1819
Mailing Address - Country:US
Mailing Address - Phone:610-667-0756
Mailing Address - Fax:856-858-5672
Practice Address - Street 1:566 HADDON AVE
Practice Address - Street 2:
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-1444
Practice Address - Country:US
Practice Address - Phone:856-858-9314
Practice Address - Fax:856-858-5672
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC01009000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker