MEDICARE: MS. SHELBY JAMECE MILES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	A22262	NC
2	101YM0800X	Mental Health Counselor	A22262	NC

General Provider Information

NPI Number	:	1235088618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHELBY JAMECE MILES

Provider Business Mailing Address
First Line	:	1315 CREEKSHIRE WAY APT 246
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-4054
Country	:	US
Telephone Number	:	919-641-9840
Fax Number	:

Provider Business Practice Location Address
First Line	:	2430 REYNOLDA RD
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27106-4626
Country	:	US
Telephone Number	:	336-291-7477
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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