Individual provider Active NPI

Miranda Middleton, L.P.C.

  • Professional Counselor
  • Lakewood, CO
National Provider Identifier
1710298492
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5702 Issued in CO
Practice address
777 S Wadsworth Blvd
BLDG#2, Suite 205
Lakewood, CO 80226-4300
Phone
(720) 373-9352
NPI assigned
Jun 28, 2010
Last updated
Jan 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5702 CO Primary

Addresses

Primary practice location

777 S Wadsworth Blvd
BLDG#2, Suite 205
Lakewood, CO 80226-4300

Mailing address

1875 Glen Dale Dr
Lakewood, CO 80215-3017
Phone (720) 373-9352

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
5702COMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1710298492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 GLEN DALE DR",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802153017",
            "telephone_number": "720-373-9352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 S WADSWORTH BLVD",
            "address_2": "BLDG#2, SUITE 205",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802264300",
            "telephone_number": "720-373-9352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "MIRANDA",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "5702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.