Active NPI
Courtney L Miles, LCSW
- Clinical Social Worker
- Yarmouth, ME
National Provider Identifier
1962783845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC15064
- Practice address
- 40 Forest Falls Dr
Yarmouth, ME 04096-7005 - Phone
- (207) 807-7762
- NPI assigned
- Sep 6, 2011
- Last updated
- Feb 16, 2021
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC15064 | ME | Primary |
Addresses
Primary practice location
40 Forest Falls Dr
Yarmouth, ME 04096-7005
Mailing address
40 Forest Falls Dr
Yarmouth, ME 04096-7005
Phone (207) 807-7762
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 23, 2021 through Mar 23, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC15064 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613433600000",
"number": "1962783845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 FOREST FALLS DR",
"city": "YARMOUTH",
"state": "ME",
"postal_code": "040967005",
"telephone_number": "207-807-7762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 FOREST FALLS DR",
"city": "YARMOUTH",
"state": "ME",
"postal_code": "040967005",
"telephone_number": "207-807-7762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILES",
"first_name": "COURTNEY",
"middle_name": "L",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-06",
"last_updated": "2021-02-16",
"certification_date": "2021-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC15064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yarmouth, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.