Miranda Nicole Medina

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6851114942 Issued in MI

Practice address

500 Hancock St
Saginaw, MI 48602-4224

Phone

(989) 797-3400

Fax

(989) 799-0206

NPI assigned

May 18, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Child and Family Service of Saginaw County

  • Addiction (Substance Use Disorder) Counselor
  • Saginaw, MI
  • NPI 1124763495
  NPD (past)
• Child and Family Service of Saginaw County

  • Clinical Social Worker
  • Saginaw, MI
  • NPI 1720069602
  NPD (past)

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1265179527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HANCOCK ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024224",
            "telephone_number": "989-797-3400",
            "fax_number": "989-799-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HANCOCK ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024224",
            "telephone_number": "989-797-3400",
            "fax_number": "989-799-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "MIRANDA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851114942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.sccmha.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 Hancock St",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486024224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Med Shoppee PC (Med Shoppee)
• Med-Trans Corporation
• Medical Plaza DME PLLC
• Medicena, LLC
• Jessica Gail Medina, L.M.T.
• Rhonda Medina, LRRT
• Meditex Supplies Inc
• Medley a Larkin D O P C
• Medpeds Healthcare, P.C.
• Medproconnect LLC

• Clinical Social Worker in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.