Active NPI
Miles H Overholt III, DSW
- Marriage & Family Therapist
- Cinnaminson, NJ
National Provider Identifier
1922214568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 756
- Practice address
- 106 Monticello Dr
Cinnaminson, NJ 08077-4378 - Phone
- (856) 786-9355
- Fax
- (856) 786-8642
- NPI assigned
- May 14, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 756 | NJ | Primary |
Addresses
Primary practice location
106 Monticello Dr
Cinnaminson, NJ 08077-4378
Mailing address
PO Box 2349
Cinnaminson, NJ 08077-5349
Phone (856) 786-9355
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 756 | Other | NJ | MARRIAGE & FAMILY THERAPY |
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 |
|---|---|---|---|
| 756 | NJ | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922214568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2349",
"city": "CINNAMINSON",
"state": "NJ",
"postal_code": "080775349",
"telephone_number": "856-786-9355",
"fax_number": "856-786-8642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 MONTICELLO DR",
"city": "CINNAMINSON",
"state": "NJ",
"postal_code": "080774378",
"telephone_number": "856-786-9355",
"fax_number": "856-786-8642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OVERHOLT",
"first_name": "MILES",
"middle_name": "H",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NJ",
"license": "756",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARRIAGE & FAMILY THERAPY",
"identifier": "756",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cinnaminson, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.