Provider Demographics
NPI:1538539689
Name:MIELE, VERONICA (LCSW)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:MIELE
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 1:2140 N HOLLYWOOD WAY UNIT 11536
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91510-8198
Mailing Address - Country:US
Mailing Address - Phone:818-669-0428
Mailing Address - Fax:
Practice Address - Street 1:16350 FILBERT ST
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-1002
Practice Address - Country:US
Practice Address - Phone:213-334-9215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW882581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical