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NPI Code Detail

MEDICARE: ROBERT C. MILES M.S. ED. LCSW

MEDICARE: ROBERT C. MILES M.S. ED. LCSW
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
11041C0700XClinical Social Worker904-123WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356515399
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT C. MILES M.S. ED. LCSW
Provider Business Mailing Address
First Line : N3152 STATE RD. 81
Second Line : GREEN COUNTY HUMAN SERVICES
City : MONROE
State : WI
Zip : 53566-9397
Country : US
Telephone Number : 608-328-9311
Fax Number : 608-328-9490
Provider Business Practice Location Address
First Line : N3152 STATE RD. 81
Second Line : GREEN COUNTY HUMAN SERVICES
City : MONROE
State : WI
Zip : 53566-8821
Country : US
Telephone Number : 608-328-9311
Fax Number : 608-328-9490
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2008
Last Update Date : 04/22/2008

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