Active NPI
Logan James Miles
- Mental Health Counselor
- Cookeville, TN
National Provider Identifier
1487424222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 5264
- Practice address
- 441 E Broad St Ste P
Cookeville, TN 38501-3390 - Phone
- (615) 549-7740
- NPI assigned
- Jan 3, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 5264 | TN | Primary |
Addresses
Primary practice location
441 E Broad St Ste P
Cookeville, TN 38501-3390
Mailing address
1054 Walton LN
Cookeville, TN 38501-1863
Phone (615) 549-7740
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5264 | TN | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704240000000",
"number": "1487424222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1054 WALTON LN",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385011863",
"telephone_number": "615-549-7740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "441 E BROAD ST STE P",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385013390",
"telephone_number": "615-549-7740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILES",
"first_name": "LOGAN",
"middle_name": "JAMES",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-03",
"last_updated": "2024-01-03",
"certification_date": "2024-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TN",
"license": "5264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cookeville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.