Individual provider Active NPI

Chloe M Mirande, LBS

  • Psychologist
  • Newtown, PA
National Provider Identifier
1225659071
Registry record updated May 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
BH004862 Issued in PA
Practice address
170 Pheasant Run
Newtown, PA 18940-1877
Phone
(215) 620-8961
NPI assigned
May 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X BH004862 PA Primary

Addresses

Primary practice location

170 Pheasant Run
Newtown, PA 18940-1877

Mailing address

800 Trenton Rd # M350
Langhorne, PA 19047-5674
Phone (215) 620-8961

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

State licenses

LicenseStateTypeSpecialty
BH004862PAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1225659071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 TRENTON RD # M350",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190475674",
            "telephone_number": "215-620-8961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 PHEASANT RUN",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401877",
            "telephone_number": "215-620-8961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDE",
        "first_name": "CHLOE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-04",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "BH004862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; 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.