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General NPI Number Information
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NPI Number | 1871257477
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Entity Type | Organization
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Legal Business Name | CREATING MILESTONES
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Dates
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Enumeration Date | 10/29/2021
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 2710 S MAIN ST STE E
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City | SALISBURY
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State | NC
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Zip | 28147-7916
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Country | US
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Telephone | 704-431-4393
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Fax |
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Provider Business Mailing Address
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Address Line | 2710 S MAIN ST STE E
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City | SALISBURY
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State | NC
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Zip | 28147-7916
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Country | US
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Telephone | 704-431-4393
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Fax | 704-431-4628
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Authorized Official
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Title or Position | CEO
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Name | JAMIE LYNN MILES
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Credential | LCMHC
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Telephone | 704-777-9600
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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