Provider Demographics
NPI:1902035322
Name:MILES, MEREDITH L (LCSW)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:L
Last Name:MILES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-3739
Mailing Address - Country:US
Mailing Address - Phone:518-792-3231
Mailing Address - Fax:303-617-2397
Practice Address - Street 1:120 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3739
Practice Address - Country:US
Practice Address - Phone:518-792-3231
Practice Address - Fax:518-792-2557
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0811461041C0700X
CO14621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical