Individual provider Active NPI

Debra S. Pitner-Miracle, LPC

  • Mental Health Counselor
  • Oshkosh, WI
National Provider Identifier
1700842911
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2873-125 Issued in WI
Practice address
303 Pearl Ave
Suite C
Oshkosh, WI 54901-4774
Phone
(920) 233-4557
Fax
(920) 233-5644
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2873-125 WI Primary

Addresses

Primary practice location

303 Pearl Ave
Suite C
Oshkosh, WI 54901-4774

Mailing address

PO Box 679
Oshkosh, WI 54903-0679
Phone (920) 233-4557

Other identifiers 1

IdentifierTypeStateIssuer
39752100MedicaidWI

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

LicenseStateTypeSpecialty
2873-125WIMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1700842911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 679",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549030679",
            "telephone_number": "920-233-4557",
            "fax_number": "920-233-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 PEARL AVE",
            "address_2": "SUITE C",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549014774",
            "telephone_number": "920-233-4557",
            "fax_number": "920-233-5644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITNER-MIRACLE",
        "first_name": "DEBRA",
        "middle_name": "S.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "2873-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39752100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; 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.