Individual provider Active NPI

Eda S. Flores-Miranda, MSW, LCSW

  • Clinical Social Worker
  • Normal, IL
National Provider Identifier
1194933093
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149013208 Issued in IL
Practice address
1304 Franklin Ave
Normal, IL 61761-3558
Phone
(309) 268-5312
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149013208 IL Primary
Social Worker 104100000X 149013208 IL

Addresses

Primary practice location

1304 Franklin Ave
Normal, IL 61761-3558

Mailing address

611 W Park St
Urbana, IL 61801-2501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081220000029 IL Practitioner - Clinical Social Worker 9638231921 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149013208ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carle West Physician Group Inc CurrentSince Jul 28, 2021 Accepting new patients
Carle Health Care Incorporated CurrentSince Oct 4, 2025 Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

1304 Franklin Ave
Normal, IL 61761
Phone (309) 268-3590

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1194933093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 FRANKLIN AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613558",
            "telephone_number": "309-268-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES-MIRANDA",
        "first_name": "EDA",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149013208",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149013208",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

Verify at the official NPI Registry.