Miranda L Johnson, BCABA

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

0-17-7940 Issued in MI

Practice address

9280 S Midway Rd
Brimley, MI 49715-9223

Phone

(906) 630-0983

NPI assigned

Aug 14, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502668800000",
    "number": "1013433846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9280 S MIDWAY RD",
            "city": "BRIMLEY",
            "state": "MI",
            "postal_code": "497159223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9280 S MIDWAY RD",
            "city": "BRIMLEY",
            "state": "MI",
            "postal_code": "497159223",
            "telephone_number": "906-630-0983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MIRANDA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "BCABA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-14",
        "last_updated": "2017-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "MI",
            "license": "0-17-7940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dolly Marie Coullard, NP-C
• Lucy Parish Dewildt, PHARM D
• Lynda Gregorini, RDH
• Rachel Lindsay Hileman, LLMSW
• Wendy K Jamros, RNP
• Renee A Johnson, LMSW
• Alicia Michelle Kasper, PHARMD
• Jaquelin Killips, RPH
• Anthony Joseph Langenfeld Jr., DO
• Sherri Larock-Macdonald, LMSW

• All providers in Brimley, MI
• Assistant Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.