Chrystal Autumn Miles, LCDCIII

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

140643 Issued in OH

Practice address

27750 State Route 7
Marietta, OH 45750-5147

Phone

(740) 371-5160

NPI assigned

Aug 30, 2017

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

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": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1376061333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9403 KENWOOD RD",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452426895",
            "telephone_number": "330-687-4731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27750 STATE ROUTE 7",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457505147",
            "telephone_number": "740-371-5160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9403 Kenwood Rd",
            "address_purpose": "LOCATION",
            "city": "Blue Ash",
            "state": "OH",
            "postal_code": "452426895",
            "country_code": "US",
            "telephone_number": "330-687-4731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILES",
        "first_name": "CHRYSTAL",
        "middle_name": "AUTUMN",
        "credential": "LCDCIII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "140643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Marietta, OH
• Providers in Marietta, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.