Individual provider Active NPI

Miranda Lane Bivens Filamini, LCSW, MFTA

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1649621749
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
253769 Issued in KY
Practice address
1979 Richmond Dr Ste 3
Louisville, KY 40205-1411
Phone
(502) 230-8694
Fax
(502) 331-6062
NPI assigned
Jun 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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
Clinical Social Worker 1041C0700X 253769 KY Primary

Addresses

Primary practice location

1979 Richmond Dr Ste 3
Louisville, KY 40205-1411

Mailing address

1630 Deer LN
Louisville, KY 40205-1216
Phone (270) 314-0543

Other practice location 1

1601 Concord Pike
Suite 68
Wilmington, DE 19803-3612
Phone (302) 655-2627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2024 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1649621749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 DEER LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402051216",
            "telephone_number": "270-314-0543",
            "fax_number": "502-331-6062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1979 RICHMOND DR STE 3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402051411",
            "telephone_number": "502-230-8694",
            "fax_number": "502-331-6062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Concord Pike",
            "address_2": "Suite 68",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198033612",
            "country_code": "US",
            "telephone_number": "302-655-2627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FILAMINI",
        "first_name": "MIRANDA",
        "middle_name": "LANE BIVENS",
        "credential": "LCSW, MFTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "253769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.