Gina Renee Miles, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

60693174 Issued in WA

Practice address

221 W Wynooche Ave Unit B
Montesano, WA 98563-4401

Phone

(360) 797-5241

Fax

(360) 249-8495

NPI assigned

Feb 15, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Gina Renee Fleming Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hope Revisited Counseling Services PLLC

  dba Hope Revisited Counseling Services

  • Clinical Social Worker
  • South Bend, WA
  • NPI 1740877638
  Medicare reassignment NPD Authorized official
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  WA

  Medicare reassignment

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

{
    "created_epoch": "1581724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581724800000",
    "number": "1124651419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W WYNOOCHE AVE UNIT B",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985634401",
            "telephone_number": "360-797-5241",
            "fax_number": "360-249-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W WYNOOCHE AVE UNIT B",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985634401",
            "telephone_number": "360-797-5241",
            "fax_number": "360-249-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "GINA",
        "middle_name": "RENEE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-15",
        "last_updated": "2020-02-15",
        "certification_date": "2020-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "60693174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "FLEMING",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leslie Luallin
• Aubrianna Rachelle McCann
• Evelyn McManus
• Juan Miguel Fernandez Mendoza, PT
• Mens Pharmacy LLC (MENS Pharmacy)
• Judith J Miller, ARNP
• Montesano Internal Medicine, PS
• Montesano Physical Therapy Inc.
• Montesano School District
• Montesano Spa Works and Massage, LLC

• Clinical Social Worker in Montesano, WA
• Providers in Montesano, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.