Miranda Aulie, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

26196 Issued in MN

Practice address

4682 Wilderness CT # 103
Brainerd, MN 56401-2834

Phone

(218) 820-7671

Fax

(218) 600-5500

NPI assigned

Jun 13, 2023

Last updated

Jun 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 15, 2025 through Jan 15, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Wishing Well Therapy Services

  • Adult Mental Health Clinic/Center
  • Baxter, MN
  • NPI 1427827054
  NPD Authorized official
• Jennifer Vaughn Therapy Services LLC

  • Community/Behavioral Health Agency
  • Nisswa, MN
  • NPI 1609290691

  Clinical

  NPD (past)

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1487338117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4682 WILDERNESS CT # 103",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564012834",
            "telephone_number": "218-820-7671",
            "fax_number": "218-600-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4682 WILDERNESS CT # 103",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564012834",
            "telephone_number": "218-820-7671",
            "fax_number": "218-600-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AULIE",
        "first_name": "MIRANDA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia M Archibald Swanson, OD
• Ashley Roberts Therapy Services
• Edward Martin Asker, R PH
• Peter R Ataro, MD
• Anastasia Atchley, LPCC
• Muhammad Waqar Azeem, MD
• Robert P Bacon, MD
• Audriana Bagwell, LICSW
• Camellia Ranee Bailey, RN
• Abigail Ann Baillif, CNP

• Clinical Social Worker in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.