Susan Necole Sturdivant Miles, LPC,NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC014502 Issued in GA

Practice address

5176 Mainstreet Park Dr
Stone Mountain, GA 30088-2440

Phone

(706) 587-9955

NPI assigned

Mar 24, 2014

Last updated

Feb 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Uplift Behavioral Health PC

  • Adult Mental Health Clinic/Center
  • Bethesda, MD
  • NPI 1629740410

  GA

  Medicare reassignment

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

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1407273816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5176 MAINSTREET PARK DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300882440",
            "telephone_number": "706-587-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5176 MAINSTREET PARK DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300882440",
            "telephone_number": "706-587-9955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "307 LEE RD 441",
            "address_purpose": "LOCATION",
            "city": "phenix city",
            "state": "AL",
            "postal_code": "36870",
            "country_code": "US",
            "telephone_number": "706-587-9955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STURDIVANT MILES",
        "first_name": "SUSAN",
        "middle_name": "NECOLE",
        "credential": "LPC,NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC014502",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Strain, AIDE
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• Andrea Streeter
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• Lacey Strozier, CCC-SLP
• Miranda Sturdivant
• Alyssa Jill Style, D.O.
• Narayan Subedi
• Sublime Transit LLC
• Success Dynamics Incorporated

• Professional Counselor in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.