Healthcare Provider Details

I. General information

NPI: 1538539689
Provider Name (Legal Business Name): VERONICA MIELE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2015
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16350 FILBERT ST
SYLMAR CA
91342-1002
US

IV. Provider business mailing address

2140 N HOLLYWOOD WAY UNIT 11536
BURBANK CA
91510-8198
US

V. Phone/Fax

Practice location:
  • Phone: 213-334-9215
  • Fax:
Mailing address:
  • Phone: 818-669-0428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW88258
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: