Healthcare Provider Details

I. General information

NPI: 1316481948
Provider Name (Legal Business Name): HEIDI B MIGLIORE MSW, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2016
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 JOHN GLENN HWY
CAMBRIDGE OH
43725
US

IV. Provider business mailing address

841 STEUBENVILLE AVE
CAMBRIDGE OH
43725-2301
US

V. Phone/Fax

Practice location:
  • Phone: 740-439-4428
  • Fax: 740-439-3389
Mailing address:
  • Phone: 855-692-7247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1000269
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCDCIII.162279
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberI.2002530
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: