Tracie Adele Miles, MA LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2008036457 Issued in MO

Practice address

426 E. 5TH St.
3Rd Floor
Washington, MO 63090

Phone

(314) 303-3602

Fax

(636) 293-1117

NPI assigned

May 20, 2009

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1487889390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 E. 5TH ST.",
            "address_2": "3RD FLOOR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "63090",
            "telephone_number": "314-303-3602",
            "fax_number": "636-293-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 E. 5TH ST.",
            "address_2": "3RD FLOOR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "63090",
            "telephone_number": "314-303-3602",
            "fax_number": "636-293-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "TRACIE",
        "middle_name": "ADELE",
        "name_prefix": "Ms.",
        "credential": "MA LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-20",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2008035457",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2008036457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Washington, MO
• Providers in Washington, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; 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.