Individual provider Active NPI

Miranda Hakim, SLP

  • Speech-Language Pathologist
  • Oak Park, MI
National Provider Identifier
1699361139
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7151013274 Issued in MI
Practice address
25900 Greenfield Rd Ste 100
Oak Park, MI 48237-1297
Phone
(248) 788-4300
NPI assigned
Dec 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7151013274 MI Primary

Addresses

Primary practice location

25900 Greenfield Rd Ste 100
Oak Park, MI 48237-1297

Mailing address

25900 Greenfield Rd Ste 100
Oak Park, MI 48237-1297
Phone (248) 788-4300

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
7151013274MIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1699361139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25900 GREENFIELD RD STE 100",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371297",
            "telephone_number": "248-788-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25900 GREENFIELD RD STE 100",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371297",
            "telephone_number": "248-788-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKIM",
        "first_name": "MIRANDA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7151013274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.