Miranda Dianne Dudley, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

12960 Issued in TN

Practice address

2917 N Highland Ave
Jackson, TN 38305-3407

Phone

(731) 300-1010

NPI assigned

Dec 23, 2025

Sex

Female

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

Practice roles

Locations

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.

• Feed Your Soul LLC

  • Clinical Social Worker
  • Jackson, TN
  • NPI 1215410816
  NPD
• Thrive West Tennessee

  • Clinical Social Worker
  • Jackson, TN
  • NPI 1790472397
  NPD (past)

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

{
    "created_epoch": "1766448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1306701156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5194 OLD HIGHWAY 20",
            "city": "FRIENDSHIP",
            "state": "TN",
            "postal_code": "380344651",
            "telephone_number": "731-819-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2917 N HIGHLAND AVE",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053407",
            "telephone_number": "731-300-1010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "802 Troy Ave",
            "address_purpose": "LOCATION",
            "city": "Dyersburg",
            "state": "TN",
            "postal_code": "380243239",
            "country_code": "US",
            "telephone_number": "731-300-1010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "MIRANDA",
        "middle_name": "DIANNE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-23",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "12960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Mary Draper, MS, RD, LDN
• Jeremy Michael Draper, MD
• Richard Key Drewery, PHD
• Amy P Driscoll, PT
• Elliott Hodges Dudley, D.D.S.
• Kristi Deanne Duffield, PA-C
• Joseph Raleigh Duke III, PA-C
• Sarah Wilhite Duke, SLP
• Caitlyn Manning Dulaney
• Hunter Allen Dulaney, MD

• Social Worker in Jackson, TN
• Providers in Jackson, TN by specialty
• Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; 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.