Provider Demographics
NPI:1316635121
Name:MILES, LASHAWNDA ASHLEY (BSW)
Entity type:Individual
Prefix:
First Name:LASHAWNDA
Middle Name:ASHLEY
Last Name:MILES
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 26TH ST
Mailing Address - Street 2:
Mailing Address - City:DUNBAR
Mailing Address - State:WV
Mailing Address - Zip Code:25064-1621
Mailing Address - Country:US
Mailing Address - Phone:304-545-0984
Mailing Address - Fax:
Practice Address - Street 1:602 26TH ST
Practice Address - Street 2:
Practice Address - City:DUNBAR
Practice Address - State:WV
Practice Address - Zip Code:25064-1621
Practice Address - Country:US
Practice Address - Phone:304-545-0984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor