Individual provider Active NPI

Miranda Hope Wichelns, LCSW

  • Clinical Social Worker
  • Berthoud, CO
National Provider Identifier
1356213532
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09930593 Issued in CO
Practice address
2572 Southwind Rd
Berthoud, CO 80513-7196
Phone
(818) 237-0586
NPI assigned
Sep 18, 2025
Last updated
Oct 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW.09930593 CO Primary

Addresses

Primary practice location

2572 Southwind Rd
Berthoud, CO 80513-7196

Mailing address

2572 Southwind Rd
Berthoud, CO 80513-7196
Phone (818) 237-0586

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

LicenseStateTypeSpecialty
CSW.09930593COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1758153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1356213532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2572 SOUTHWIND RD",
            "city": "BERTHOUD",
            "state": "CO",
            "postal_code": "805137196",
            "telephone_number": "818-237-0586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2572 SOUTHWIND RD",
            "city": "BERTHOUD",
            "state": "CO",
            "postal_code": "805137196",
            "telephone_number": "818-237-0586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICHELNS",
        "first_name": "MIRANDA",
        "middle_name": "HOPE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-18",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09930593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berthoud, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.