MEDICARE: DONNA MARIA MILES ASARE 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
1	101YM0800X	Mental Health Counselor	LCSW99174	CA

General Provider Information

NPI Number	:	1841864394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA MARIA MILES ASARE LCSW

Provider Business Mailing Address
First Line	:	2024 VILLA DR APT 107
Second Line	:
City	:	BAY POINT
State	:	CA
Zip	:	94565-1367
Country	:	US
Telephone Number	:	925-978-6037
Fax Number	:

Provider Business Practice Location Address
First Line	:	2024 VILLA DR APT 107
Second Line	:
City	:	BAY POINT
State	:	CA
Zip	:	94565-1367
Country	:	US
Telephone Number	:	925-978-6037
Fax Number	:

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

Provider Enumeration Date	:	05/19/2021
Last Update Date	:	05/19/2021

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