Provider Demographics
NPI:1104424175
Name:MILES, ANNE (LCSW-R)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:MILES
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-2201
Mailing Address - Country:US
Mailing Address - Phone:716-218-1400
Mailing Address - Fax:716-332-2820
Practice Address - Street 1:2636 W STATE ST STE 301
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1859
Practice Address - Country:US
Practice Address - Phone:716-372-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00083830104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker