Individual provider Active NPI

Miranda Quinn Robinson

  • Marriage & Family Therapist
  • Salem, OR
National Provider Identifier
1780988626
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF 60630 Issued in CA
Practice address
2355 State St Ste 101
Salem, OR 97301-4541
Phone
(530) 440-1201
NPI assigned
Jan 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF 60630 CA Primary

Addresses

Primary practice location

2355 State St Ste 101
Salem, OR 97301-4541

Mailing address

PO Box 857
Seaside, OR 97138-0857
Phone (530) 440-1201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20240503001027 OR Practitioner - Marriage and Family Therapist 7012357304 Practice locations: Salem, OR

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2355 State St
Suite 101
Salem, OR 97301-4541
Phone (530) 440-1201

PO Box
Suite 857
Seaside, OR 97138-0857

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IMF 60630CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Anchored Healing Therapy LLC CurrentSince Oct 8, 2023 Accepting new patients
Remi Vista Inc. Past Accepting new patients

Organizations & group practices 2

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": "1294358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1780988626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 857",
            "city": "SEASIDE",
            "state": "OR",
            "postal_code": "971380857",
            "telephone_number": "530-440-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 STATE ST STE 101",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014541",
            "telephone_number": "530-440-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "MIRANDA",
        "middle_name": "QUINN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-07",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF 60630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.