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NPI Code Detail

MEDICARE: KATELYNN MILES

MEDICARE: KATELYNN 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
1101YA0400XAddiction (Substance Use Disorder) Counselor41823NY

General Provider Information

NPI Number : 1790624161
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYNN MILES
Provider Business Mailing Address
First Line : 1850 BRIGHTON HEN TL RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14623-2532
Country : US
Telephone Number : 585-287-5622
Fax Number : 585-287-5628
Provider Business Practice Location Address
First Line : 1850 BRIGHTON HEN TL RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14623-2532
Country : US
Telephone Number : 585-287-5622
Fax Number : 585-287-5628
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2026
Last Update Date : 03/27/2026

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