Individual provider Active NPI

Miranda Paige Byl, LLMSW

  • Clinical Social Worker
  • Byron Center, MI
National Provider Identifier
1417785205
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851118655 Issued in MI
Practice address
8250 Byron Creek Dr
Byron Center, MI 49315-9198
Phone
(616) 490-4748
NPI assigned
Jul 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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 6851118655 MI Primary

Addresses

Primary practice location

8250 Byron Creek Dr
Byron Center, MI 49315-9198

Mailing address

10431 Country TRL NW
Grand Rapids, MI 49534-9633
Phone (616) 490-4748

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
6851118655MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1417785205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10431 COUNTRY TRL NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495349633",
            "telephone_number": "616-490-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8250 BYRON CREEK DR",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493159198",
            "telephone_number": "616-490-4748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYL",
        "first_name": "MIRANDA",
        "middle_name": "PAIGE",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851118655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Byron Center, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.