Provider Demographics
NPI:1750448882
Name:MILES, DEANNA RILEY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:RILEY
Last Name:MILES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12A WESTBANK EXPRESSWAY #205
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70053-3659
Mailing Address - Country:US
Mailing Address - Phone:504-701-0904
Mailing Address - Fax:504-362-5163
Practice Address - Street 1:12A WESTBANK EXPRESSWAY #205
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-3659
Practice Address - Country:US
Practice Address - Phone:504-362-5122
Practice Address - Fax:504-362-5163
Is Sole Proprietor?:No
Enumeration Date:2007-01-01
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA29151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical