Individual provider Active NPI

Corey Miletello, LCSW

  • Clinical Social Worker
  • Winona, MS
National Provider Identifier
1386369155
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C10352 Issued in MS
Practice address
740 Middleton Rd
Winona, MS 38967-2024
Phone
(662) 614-8656
NPI assigned
Oct 5, 2022
Last updated
Oct 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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 C10352 MS Primary

Addresses

Primary practice location

740 Middleton Rd
Winona, MS 38967-2024

Mailing address

740 Middleton Rd
Winona, MS 38967-2024
Phone (662) 614-8656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20241021003052 MS Practitioner - Clinical Social Worker 1052843620 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Starkville Wellness GroupGroup PAC ID 3072982545, 8 clinicians

Practice addresses (Care Compare)

100 Starr Ave
Suite K
Starkville, MS 39759-4032
Phone (662) 340-5947

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C10352MSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Starkville Wellness Group CurrentSince Oct 8, 2025 Accepting new patients
Restore Therapy Group Clinical CurrentSince Sep 1, 2024 Accepting new patients

Locations

28 Glenwood Dr
Ste 1
Columbus, MS 39705
Phone (601) 941-7754

100 Starr Ave
Ste K
Starkville, MS 39759
Phone (662) 340-5947

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1386369155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 MIDDLETON RD",
            "city": "WINONA",
            "state": "MS",
            "postal_code": "389672024",
            "telephone_number": "662-614-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 MIDDLETON RD",
            "city": "WINONA",
            "state": "MS",
            "postal_code": "389672024",
            "telephone_number": "662-614-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILETELLO",
        "first_name": "COREY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C10352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winona, MS

Sources for this page

Verify at the official NPI Registry.