Provider Demographics
NPI:1972521037
Name:MILES, ELIENAY HERNANDEZ (LCSW)
Entity type:Individual
Prefix:MS
First Name:ELIENAY
Middle Name:HERNANDEZ
Last Name:MILES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3260 WILDLIFE TRL
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-0017
Mailing Address - Country:US
Mailing Address - Phone:646-541-1142
Mailing Address - Fax:
Practice Address - Street 1:2555 55TH PL
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220
Practice Address - Country:US
Practice Address - Phone:646-541-1142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8336-1231041C0700X
NY0761961041C0700X
CA272911041C0700X
IN34006568A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical