Provider Demographics
NPI:1871175729
Name:MILES, CIERA (LCSW)
Entity type:Individual
Prefix:
First Name:CIERA
Middle Name:
Last Name:MILES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CIERA
Other - Middle Name:
Other - Last Name:DONHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1028
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47547-1028
Mailing Address - Country:US
Mailing Address - Phone:812-996-8478
Mailing Address - Fax:
Practice Address - Street 1:721 W 13TH ST STE 121
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-1856
Practice Address - Country:US
Practice Address - Phone:812-996-5780
Practice Address - Fax:812-996-5784
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34009388A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical