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General NPI Number Information
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NPI Number | 1871484741
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Entity Type | Organization
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Legal Business Name | MILES INSTITUTE OF INTEGRAL LIVING, LLC
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 1633 E 30TH ST STE 1
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City | BALTIMORE
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State | MD
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Zip | 21218-6279
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Country | US
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Telephone | 301-821-1932
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Fax |
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Provider Business Mailing Address
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Address Line | 1633 E 30TH ST STE 1
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City | BALTIMORE
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State | MD
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Zip | 21218-6279
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Country | US
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Telephone | 301-821-1932
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOTHERAPIST
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Name | JUSTIN F MILES
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Credential | MA, LCPC
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Telephone | 301-821-1932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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