Individual provider Active NPI

Miranda Learmonth Tucker, MSW, LCSW

  • Clinical Social Worker
  • Evergreen, CO
National Provider Identifier
1760635395
Registry record updated May 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW2095 Issued in CO
Practice address
3092 Evergreen Pkwy Ste 202
Evergreen, CO 80439-7849
Phone
(720) 924-1048
NPI assigned
Oct 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW2095 CO Primary

Addresses

Primary practice location

3092 Evergreen Pkwy Ste 202
Evergreen, CO 80439-7849

Mailing address

3092 Evergreen Pkwy Ste 202
Evergreen, CO 80439-7849
Phone (720) 924-1048

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address miranda@mirandatucker.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20151005001162 CO Practitioner - Clinical Social Worker 6103134572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

720 S Colorado Blvd
PH North
Denver, CO 80246-1904
Phone (844) 843-7279

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW2095COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Jan 29, 2025 Accepting new patients

Locations

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

Organizations & group practices 1

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": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1760635395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3092 EVERGREEN PKWY STE 202",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804397849",
            "telephone_number": "720-924-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3092 EVERGREEN PKWY STE 202",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804397849",
            "telephone_number": "720-924-1048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MIRANDA",
        "middle_name": "LEARMONTH",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW2095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "miranda@mirandatucker.com",
            "affiliation": "N",
            "address_1": "3092 Evergreen Pkwy Ste 202",
            "city": "Evergreen",
            "state": "CO",
            "country_code": "US",
            "postal_code": "804397849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evergreen, CO

Sources for this page

Verify at the official NPI Registry.