Individual provider Active NPI

Robert C. Miles, M.S. ED. LCSW

  • Clinical Social Worker
  • Monroe, WI
National Provider Identifier
1356515399
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
904-123 Issued in WI
Practice address
N3152 State Rd. 81
Green County Human Services
Monroe, WI 53566-8821
Phone
(608) 328-9311
Fax
(608) 328-9490
NPI assigned
Apr 22, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 904-123 WI Primary

Addresses

Primary practice location

N3152 State Rd. 81
Green County Human Services
Monroe, WI 53566-8821

Mailing address

N3152 State Rd. 81
Green County Human Services
Monroe, WI 53566-9397
Phone (608) 328-9311

Other identifiers 1

IdentifierTypeStateIssuer
39615600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
904-123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1356515399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N3152 STATE RD. 81",
            "address_2": "GREEN COUNTY HUMAN SERVICES",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535669397",
            "telephone_number": "608-328-9311",
            "fax_number": "608-328-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N3152 STATE RD. 81",
            "address_2": "GREEN COUNTY HUMAN SERVICES",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535668821",
            "telephone_number": "608-328-9311",
            "fax_number": "608-328-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "ROBERT",
        "middle_name": "C.",
        "credential": "M.S. ED. LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "904-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39615600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.