Active NPI
Miranda Alexander
- Marriage & Family Therapist
- Port St Lucie, FL
National Provider Identifier
1497522916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 590 NW Peacock Blvd Ste 1
Port St Lucie, FL 34986-2213 - Phone
- (772) 348-0900
- NPI assigned
- Dec 5, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
590 NW Peacock Blvd Ste 1
Port St Lucie, FL 34986-2213
Mailing address
151 SW Palm Dr Apt 208
Port Saint Lucie, FL 34986-1795
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724716800000",
"number": "1497522916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 SW PALM DR APT 208",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349861795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 NW PEACOCK BLVD STE 1",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349862213",
"telephone_number": "772-348-0900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALEXANDER",
"first_name": "MIRANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-12-05",
"last_updated": "2024-08-27",
"certification_date": "2024-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.