Vincent Miles, PSY.D. LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP5676 Issued in MN

Practice address

606 25TH Ave S
Suite 105
Saint Cloud, MN 56301-4800

Phone

(320) 247-4737

Fax

(320) 365-0080

NPI assigned

Aug 15, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Miles Psychological Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Cloud, MN
  • NPI 1548637507
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1912255449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 25TH AVE S",
            "address_2": "SUITE 105",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014800",
            "telephone_number": "320-247-4737",
            "fax_number": "320-365-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 25TH AVE S",
            "address_2": "SUITE 105",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014800",
            "telephone_number": "320-247-4737",
            "fax_number": "320-365-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "PSY.D. LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-15",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "MN",
            "license": "LP5676",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP5676",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey M Mies, DC
• Sidney Rose Milbrandt
• Kathryn Marie Milczark, RN
• Miles Psychological Services, LLC
• Emily Sutton Miles
• Milestone Counseling Inc.
• John P Miley, LAC
• Allison M Miller
• Candace Joellen Miller
• Christopher Bruce Miller, MD

• Clinical Psychologist in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.