A Mix of Emotions LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

A MIX OF EMOTIONS LLC

Practice address

9015 Woodyard Rd Ste 206
Clinton, MD 20735-4209

Phone

(240) 580-9956

NPI assigned

Jul 29, 2024

Last updated

Jul 29, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miranda Mixon, LCPCNPI 1861956419

Title

Owner/Mental Health Provider

Phone

(240) 580-9956

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Miranda Mixon, LCPC

  • Mental Health Counselor
  • Clinton, MD
  • NPI 1861956419

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1235968371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9015 WOODYARD RD STE 206",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354209",
            "telephone_number": "240-580-9956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9015 WOODYARD RD STE 206",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354209",
            "telephone_number": "240-580-9956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A MIX OF EMOTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "MIXON",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "OWNER/MENTAL HEALTH PROVIDER",
        "authorized_official_telephone_number": "240-580-9956",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.