Provider Demographics
NPI:1487882783
Name:MILES, SUSAN (LMSW)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:MILES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 W 13TH ST
Mailing Address - Street 2:4TH FLR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-1200
Mailing Address - Country:US
Mailing Address - Phone:212-645-8111
Mailing Address - Fax:
Practice Address - Street 1:320 W 13TH ST
Practice Address - Street 2:4TH FLR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-1200
Practice Address - Country:US
Practice Address - Phone:212-645-8111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076719104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker