Active NPI
Miriam S Mindeman, M.A., L.P.C.
- Counselor
- Canton, IL
National Provider Identifier
1063828176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 178.008716
- Practice address
- 229 Martin Ave
Canton, IL 61520-2520 - Phone
- (309) 647-1881
- NPI assigned
- Jul 9, 2014
- Last updated
- Jul 9, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 178.008716 | IL | Primary |
Addresses
Primary practice location
229 Martin Ave
Canton, IL 61520-2520
Mailing address
229 Martin Ave
Canton, IL 61520
Phone (309) 647-1881
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.008716 | IL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404864000000",
"number": "1063828176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "229 MARTIN AVE",
"city": "CANTON",
"state": "IL",
"postal_code": "61520",
"telephone_number": "309-647-1881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "229 MARTIN AVE",
"city": "CANTON",
"state": "IL",
"postal_code": "615202520",
"telephone_number": "309-647-1881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINDEMAN",
"first_name": "MIRIAM",
"middle_name": "S",
"credential": "M.A., L.P.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-09",
"last_updated": "2014-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "178.008716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.