Active NPI
Miranda Carroll
- Behavior Technician
- Irmo, SC
National Provider Identifier
1619790631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-390285
- Practice address
- 1084 Lake Murray Blvd
Irmo, SC 29063-2821 - Phone
- (706) 842-5330
- Fax
- (706) 842-5340
- NPI assigned
- Nov 7, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-24-390285 | SC | Primary |
Addresses
Primary practice location
1084 Lake Murray Blvd
Irmo, SC 29063-2821
Mailing address
209 7TH St FL 3
Augusta, GA 30901-1486
Phone (706) 842-5330
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-24-390285 | SC | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730937600000",
"number": "1619790631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 7TH ST FL 3",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309011486",
"telephone_number": "706-842-5330",
"fax_number": "706-842-5340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1084 LAKE MURRAY BLVD",
"city": "IRMO",
"state": "SC",
"postal_code": "290632821",
"telephone_number": "706-842-5330",
"fax_number": "706-842-5340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "MIRANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-07",
"last_updated": "2024-11-07",
"certification_date": "2024-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "SC",
"license": "RBT-24-390285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irmo, SC
- Carolina Bone & Joint PA
- Carolina Cardiology and Vascular Associates LLC
- Carolina Circle of Care
- Carolina Companion Care LLC
- Carolina Kids Therapeutic Interventions, LLC
- Lauren Camp Carsten, NP-C
- Ginger Cates
- George Franklin Causey Jr., DMD
- Center for Health Integration, Inc
- Johanna Ellen Chapman, CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.