Individual provider Active NPI

Justin Forrest Miles, MA NCC LCPC, CAC-AD

  • Mental Health Counselor
  • Baltimore, MD
National Provider Identifier
1679885933
Registry record updated Jul 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1633 E 30TH St
Baltimore, MD 21218-3726
Phone
(301) 821-1932
NPI assigned
Jul 2, 2010
Last updated
Jul 23, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

1633 E 30TH St
Baltimore, MD 21218-3726

Mailing address

1633 E 30TH St
Baltimore, MD 21218-3726
Phone (301) 821-1932

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Marissa Block LLC CurrentSince Sep 22, 2024 Accepting new patients
Miles Institute of Integral Living, LLC Current Accepting new patients
Marissa Block LLC PastSince Jul 2, 2023 Accepting new patients

Locations

200 E Joppa Rd
Ste 400
Towson, MD 21286
Phone (443) 300-6905

Organizations & group practices 3

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": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279843200000",
    "number": "1679885933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 E 30TH ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183726",
            "telephone_number": "301-821-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 E 30TH ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183726",
            "telephone_number": "301-821-1932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "JUSTIN",
        "middle_name": "FORREST",
        "name_prefix": "Mr.",
        "credential": "MA NCC LCPC, CAC-AD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-02",
        "last_updated": "2010-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.