Active NPI
Miriam E Irvin, LPC, LLP
- Mental Health Counselor
- Benton Harbor, MI
National Provider Identifier
1326110230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6401007990
- Practice address
- 1485 S M-139
Benton Harbor, MI 49022 - Phone
- (269) 925-0585
- Fax
- (269) 927-1326
- NPI assigned
- Nov 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 6301011675 | MI | |
| Mental Health Counselor | 101YM0800X | 6401007990 | MI | Primary |
Addresses
Primary practice location
1485 S M-139
Benton Harbor, MI 49022
Mailing address
1485 S M-139
Benton Harbor, MI 49022
Phone (269) 925-0585
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6401007990 | MI | MD | Mental Health Counselor |
| 6301011675 | MI | MD | Cognitive & Behavioral Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395100800000",
"number": "1326110230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1485 S M-139",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "49022",
"telephone_number": "269-925-0585",
"fax_number": "269-927-1326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1485 S M-139",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "49022",
"telephone_number": "269-925-0585",
"fax_number": "269-927-1326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRVIN",
"first_name": "MIRIAM",
"middle_name": "E",
"name_prefix": "Mrs.",
"credential": "LPC, LLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2014-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "MI",
"license": "6301011675",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6401007990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton Harbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.