Individual provider Active NPI

Mary Miranda-Tourino, LCSW

  • Clinical Social Worker
  • Plantation, FL
National Provider Identifier
1750817292
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 13353 Issued in FL
Practice address
261 N University Dr Ste 500
Plantation, FL 33324-2009
Phone
(954) 295-5526
NPI assigned
May 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X SW13353 FL
Behavior Analyst 103K00000X
Clinical Social Worker 1041C0700X SW 13353 FL Primary

Addresses

Primary practice location

261 N University Dr Ste 500
Plantation, FL 33324-2009

Mailing address

261 N University Dr Ste 500
Plantation, FL 33324-2009
Phone (954) 295-5526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190510000767 FL Practitioner - Clinical Social Worker 2567705718 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Progressive Medical Center IncGroup PAC ID 8820497423, 7 clinicians

Practice addresses (Care Compare)

10400 Griffin Rd
Suite 102
Davie, FL 33328-3320
Phone (954) 295-5526

12595 SW 137TH Ave
Suite 110
Miami, FL 33186-4218
Phone (305) 465-9379

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW13353FLMDMental Health Counselor
SW 13353FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
RF Mental Health Services LLC Behavior Analyst CurrentSince Mar 1, 2022 Accepting new patients
Dr. Michelle Channing PA CurrentSince Apr 24, 2019 Accepting new patients
Progressive Medical Center Inc Behavior Analyst CurrentSince Jun 20, 2023 Accepting new patients
Su Therapy PA Behavior Analyst Current Accepting new patients
We Belong Counseling Inc Mental Health Current Accepting new patients
We Belong Counseling Corp Mental Health CurrentSince Nov 12, 2020 Accepting new patients

Locations

10400 Griffin Rd
Ste 102
Davie, FL 33328
Phone (954) 295-5526

12595 SW 137th Ave
Ste 110
Miami, FL 33186
Phone (305) 465-9379

760 NW 107th Ave
Ste 110
Miami, FL 33172
Phone (786) 616-0363

2741 Executive Park Dr
Ste 1
Weston, FL 33331
Phone (954) 385-6750

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1750817292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 N UNIVERSITY DR STE 500",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242009",
            "telephone_number": "954-295-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 N UNIVERSITY DR STE 500",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242009",
            "telephone_number": "954-295-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA-TOURINO",
        "first_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-03",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW13353",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 13353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.