Provider Demographics
NPI:1679171540
Name:MIELE, ALYCE KRISTEN (LSW)
Entity Type:Individual
Prefix:
First Name:ALYCE
Middle Name:KRISTEN
Last Name:MIELE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1453 BARNSDALE ST # 2R
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1354
Mailing Address - Country:US
Mailing Address - Phone:172-471-7432
Mailing Address - Fax:
Practice Address - Street 1:830 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15233-1772
Practice Address - Country:US
Practice Address - Phone:412-322-2129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW135522104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker