Provider Demographics
NPI:1861946535
Name:MILEY-SCOTT, MICHELE HOPE (LCDC III, SWA)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:HOPE
Last Name:MILEY-SCOTT
Suffix:
Gender:F
Credentials:LCDC III, SWA
Other - Prefix:MS
Other - First Name:MICHELE
Other - Middle Name:HOPE
Other - Last Name:MILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1791 ALUM CREEK DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-1708
Mailing Address - Country:US
Mailing Address - Phone:614-445-8131
Mailing Address - Fax:614-827-8380
Practice Address - Street 1:18200 ST RT 4R
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040
Practice Address - Country:US
Practice Address - Phone:937-644-2838
Practice Address - Fax:937-644-3243
Is Sole Proprietor?:No
Enumeration Date:2016-08-10
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
OH081112101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator