Individual provider Active NPI

Virgelina Miranda, LCSW, LSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1477652386
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
090764-01 Issued in NY
Practice address
230 W 129TH St Apt 5B
New York, NY 10027-1909
Phone
(718) 796-5300
NPI assigned
Sep 21, 2006
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 090764-01 NY Primary
Social Worker 104100000X 44SL06902400 NJ

Addresses

Primary practice location

230 W 129TH St Apt 5B
New York, NY 10027-1909

Mailing address

230 W 129TH St Apt 5B
New York, NY 10027-1909
Phone (718) 796-5300

Other practice location 1

15 Lozaw Rd
Franklin, NJ 07416-1713
Phone (917) 943-6440

Other names 1

  • Virgelina Caunobly-Miranda Former name

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
44SL06902400NJMDSocial Worker
090764-01NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1477652386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 W 129TH ST APT 5B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100271909",
            "telephone_number": "718-796-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W 129TH ST APT 5B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100271909",
            "telephone_number": "718-796-5300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Lozaw Rd",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "NJ",
            "postal_code": "074161713",
            "country_code": "US",
            "telephone_number": "917-943-6440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "VIRGELINA",
        "credential": "LCSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "090764-01",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06902400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIRGELINA",
            "last_name": "CAUNOBLY-MIRANDA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.