Miranda Leah Demirjian, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1046 Fairfield Ave
Bridgeport, CT 06605-1116

Phone

(203) 332-3106

NPI assigned

Sep 28, 2017

Last updated

Sep 28, 2017By the provider in NPPES

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South-West Community Health Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bridgeport, CT
  • NPI 1699703686
  NPD (past)

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506556800000",
    "number": "1366951758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 PORTER LN",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051116",
            "telephone_number": "203-332-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMIRJIAN",
        "first_name": "MIRANDA",
        "middle_name": "LEAH",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2017-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236148",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carl F. Delucia, D.D.S.
• Dajauna Delvalle, LCSW
• Phaedra M Delvalle
• Nathan Demaio
• Michael Joseph Demasi, DNP, FNP-BC, APRN
• Sarah Denisco
• Susan M Denisco, APRN
• Ronalee Dennis-Nelson
• Dental Associates of Bridgeport, LLC
• Dental Centers of Fairfiled County LLC

• Social Worker in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; 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.