Miranda Macdicken

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SC61177160 Issued in WA

Practice address

21907 64TH Ave W Ste 200
Mountlake Terrace, WA 98043-6200

Phone

(253) 306-1755

NPI assigned

Nov 1, 2022

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

State licenses

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1336856137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 25TH AVE NE APT W106",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982712902",
            "telephone_number": "253-306-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21907 64TH AVE W STE 200",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980436200",
            "telephone_number": "253-306-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDICKEN",
        "first_name": "MIRANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61177160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristen Jane Luke, LMSW
• Jennifer Yong Luna, D.D.S.
• Brigid Lunder, N.D.
• Maria Luquin
• Lynnwood Child and Family Therapy PLLC
• Gordon Macdonald, RPH
• Belynda Jo Macias, LMT
• Jason Macleod, PSYD
• Mihail Madan
• Priscila Sandra Madeira Lau

• Clinical Social Worker in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.