Active NPI
Innael Todd Miranda, LAC, LPC, LMHC
- Mental Health Counselor
- Albuquerque, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC.0020508
- Practice address
- 1119 Morningside Dr NE
Albuquerque, NM 87110-6172 - Phone
- (720) 230-3326
- NPI assigned
- Jun 16, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | ACC-7097 | CO | |
| Mental Health Counselor | 101YM0800X | CTB-2023-0229 | NM | |
| Mental Health Counselor | 101YM0800X | LPC.0020508 | CO | Primary |
Addresses
Primary practice location
1119 Morningside Dr NE
Albuquerque, NM 87110-6172
Mailing address
1119 Morningside Dr NE
Albuquerque, NM 87110-6172
Phone (720) 230-3326
Other practice location 1
12101 E 2nd Ave
Suite 101
Aurora, CO 80011-8327
Phone (720) 670-7276
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACC-7097 | CO | MD | Addiction (Substance Use Disorder) Counselor |
| LPC.0020508 | CO | MD | Mental Health Counselor |
| CTB-2023-0229 | NM | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faith Works Counseling LLC | Current | Accepting new patients |
Locations
8100 Wyoming Blvd NE
Ste M4
Albuquerque, NM 87113
Phone (505) 301-1105
7441 Bartlett St NE
Ste 1C
Albuquerque, NM 87109
Phone (505) 585-1263
221 N Auburn Ave
Farmington, NM 87401
Phone (505) 600-6631
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Albuquerque, NM
- NPI 1073045688
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712534400000",
"number": "1023303070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1119 MORNINGSIDE DR NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871106172",
"telephone_number": "720-230-3326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1119 MORNINGSIDE DR NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871106172",
"telephone_number": "720-230-3326"
}
],
"practiceLocations": [
{
"address_1": "12101 E 2nd Ave",
"address_2": "Suite 101",
"address_purpose": "LOCATION",
"city": "Aurora",
"state": "CO",
"postal_code": "800118327",
"country_code": "US",
"telephone_number": "720-670-7276",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIRANDA",
"first_name": "INNAEL",
"middle_name": "TODD",
"credential": "LAC, LPC, LMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-16",
"last_updated": "2024-04-08",
"certification_date": "2024-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CO",
"license": "ACC-7097",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "CTB-2023-0229",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CO",
"license": "LPC.0020508",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.