Organization Active NPI

Miranda Babl LLC

  • Professional Counselor
  • Weston, WI
National Provider Identifier
1417837717
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MIRANDA BABL LLC
Practice address
5303 E Jelinek Ave
Weston, WI 54476-4230
Phone
(715) 574-9628
NPI assigned
Sep 5, 2025
Last updated
Sep 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Authorized official

Name
Miranda Tina Martha Babl, LPCNPI 1639688492
Title
Licensed Professional Counselor
Phone
(715) 574-9628

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

5303 E Jelinek Ave
Weston, WI 54476-4230

Mailing address

1762 McAddoe PL
Kronenwetter, WI 54455-8109
Phone (715) 574-9628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251017002893 WI Part B Supplier - Clinic/Group Practice 2860989233 Receives reassigned benefits from 1 practitioner
Practice locations: Weston, WI

National Provider Directory

National Provider Directory

Locations

5303 E Jelinek Ave
Weston, WI 54476
Phone (715) 574-9628

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1757030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757030400000",
    "number": "1417837717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1762 MCADDOE PL",
            "city": "KRONENWETTER",
            "state": "WI",
            "postal_code": "544558109",
            "telephone_number": "715-574-9628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5303 E JELINEK AVE",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544764230",
            "telephone_number": "715-574-9628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRANDA BABL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-05",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A",
        "authorized_official_last_name": "BABL",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_middle_name": "TINA MARTHA",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "715-574-9628",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.