Juan Miranda, MSW, LICSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SC61415782 Issued in WA

Practice address

4120 Meridian St Ste 220
Bellingham, WA 98226-5575

Phone

(360) 922-3030

NPI assigned

Nov 27, 2017

Last updated

Feb 29, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1073027207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 MERIDIAN ST STE 220",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982265575",
            "telephone_number": "360-922-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 MERIDIAN ST STE 220",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982265575",
            "telephone_number": "360-922-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "JUAN",
        "credential": "MSW, LICSWA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-27",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61415782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.