Active NPI
Miranda Danielle Haley
- Social Worker
- Decatur, GA
National Provider Identifier
1639711286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- MSW004070
- Practice address
- 445 Winn Way
Decatur, GA 30030-1707 - Phone
- (404) 508-7796
- NPI assigned
- Oct 15, 2019
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | MSW004070 | GA | Primary |
Addresses
Primary practice location
445 Winn Way
Decatur, GA 30030-1707
Mailing address
902 Summerbrook Dr
Atlanta, GA 30350-3070
Phone (404) 271-2607
Other practice location 1
175 Gwinnett Dr
Lawrenceville, GA 30046-8444
Phone (678) 209-2394
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 |
|---|---|---|---|
| MSW004070 | GA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666656000000",
"number": "1639711286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 SUMMERBROOK DR",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303503070",
"telephone_number": "404-271-2607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 WINN WAY",
"city": "DECATUR",
"state": "GA",
"postal_code": "300301707",
"telephone_number": "404-508-7796"
}
],
"practiceLocations": [
{
"address_1": "175 Gwinnett Dr",
"address_purpose": "LOCATION",
"city": "Lawrenceville",
"state": "GA",
"postal_code": "300468444",
"country_code": "US",
"telephone_number": "678-209-2394",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HALEY",
"first_name": "MIRANDA",
"middle_name": "DANIELLE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-15",
"last_updated": "2022-10-25",
"certification_date": "2022-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "GA",
"license": "MSW004070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.