Miranda Shawntay Roberts, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1035 Cheraw Street
Bennettsville, SC 29512

Phone

(843) 544-4060

NPI assigned

Jan 15, 2020

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• South Carolina Dept of Mental Health Accounting Office

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bennetsville, SC
  • NPI 1609979640
  NPD (past)

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1356981542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "29512",
            "telephone_number": "843-544-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 CHERAW STREET",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "29512",
            "telephone_number": "843-544-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MIRANDA",
        "middle_name": "SHAWNTAY",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405127",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Quaneaka Chintell Reed, RN
• Susan G Reed, RN
• Cindy Jamaica Rivers, CC
• Rizenson, LLC
• Rizenson, LLC
• Norma Robinson, LPC
• Rantaisha Elizabeth Robinson
• Carolyn Rogers
• Mary R Rogers, LMSW
• Tennille Rogers

• Mental Health Counselor in Bennettsville, SC
• Providers in Bennettsville, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.