Matthew Telliferald Miles, LCSW-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P013435 Issued in NC

Practice address

2409 N Elm St
Lumberton, NC 28358-3658

Phone

(910) 802-4365

NPI assigned

Jul 8, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1104488402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15081 HIGHWAY 130 E",
            "city": "FAIRMONT",
            "state": "NC",
            "postal_code": "283405553",
            "telephone_number": "910-374-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 N ELM ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583658",
            "telephone_number": "910-802-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "MATTHEW",
        "middle_name": "TELLIFERALD",
        "credential": "LCSW-A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P013435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "kingdom1medicine.com",
            "affiliation": "N",
            "address_1": "15081 Hwy 130 E",
            "city": "Fairmont",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alexandra Dais Merrell, APRN
• Metrocorp Affiliates, LTD
• Donald Eugene Metzger II, PA
• Ikram Mghazli, FNP
• Carmelo A Milano, M.D.
• Millennium Consulting, LLC
• Casey Miller, PTA
• Richard Miller
• Dennis D. Mims
• Mind Body Wellness Centre

• Clinical Social Worker in Lumberton, NC
• Providers in Lumberton, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.