Provider Demographics
NPI:1669827507
Name:MIELE, MARK (LPC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:MIELE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 SLEDGE DR STE B
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-3000
Mailing Address - Country:US
Mailing Address - Phone:251-473-3410
Mailing Address - Fax:251-476-4454
Practice Address - Street 1:1340 SLEDGE DR STE B
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-3000
Practice Address - Country:US
Practice Address - Phone:251-473-3410
Practice Address - Fax:251-476-4454
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3543101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional