Kristin Miranda

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

777 Central Ave Ste 17
Highland Park, IL 60035-3246

Phone

(847) 441-5600

Fax

(847) 441-7968

NPI assigned

May 17, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1386493690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 CENTRAL AVE STE 17",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353246",
            "telephone_number": "847-441-5600",
            "fax_number": "847-441-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 CENTRAL AVE STE 17",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353246",
            "telephone_number": "847-441-5600",
            "fax_number": "847-441-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary O'Halloran Miller
• Deborah S. Milling, M.A.
• Mindfully Well PLLC
• Minx Wellness, PC
• Sanhareeb Kaena Minyanish
• Joseph Mishell, M.D.
• Melissa Kate Modro, PA-C
• Matthew Richard Moersch
• Elena Molloy
• Holly Moloney

• Mental Health Counselor in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.