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General NPI Number Information
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NPI Number | 1760936918
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Entity Type | Individual
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Provider Name | HOLLIE MILES LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/04/2016
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Last Update Date | 11/08/2019
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Provider Practice Location Address
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Address Line | 1905 HUGUENOT RD STE 303C
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235
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Country | US
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Telephone | 804-346-6327
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 72984
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-8023
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Country | US
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Telephone | 434-572-7184
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0710102921
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904009557
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License Number State | VA
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