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NPI Code Detail

MEDICARE: ELIZABETH MARY MILES LPC

MEDICARE: ELIZABETH MARY MILES LPC
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
1101YA0400XAddiction (Substance Use Disorder) CounselorLPC-3901ID
2101YM0800XMental Health CounselorLPC-3901ID
3101YP2500XProfessional CounselorLPC-3901ID

General Provider Information

NPI Number : 1356519870
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH MARY MILES LPC
Provider Business Mailing Address
First Line : 317 W 6TH ST STE 208
Second Line :
City : MOSCOW
State : ID
Zip : 83843-2387
Country : US
Telephone Number : 208-882-3504
Fax Number : 877-935-2107
Provider Business Practice Location Address
First Line : 317 W 6TH ST STE 208
Second Line :
City : MOSCOW
State : ID
Zip : 83843-2387
Country : US
Telephone Number : 208-882-3504
Fax Number : 877-935-2107
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2008
Last Update Date : 12/02/2023

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Directions to “ ELIZABETH MARY MILES LPC” Practice Location

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