Miranda Kimberly Wadley, LSW

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C.1801112 Issued in OH

Practice address

23215 Commerce Park
Cleveland, OH 44122

Phone

(216) 224-7331

NPI assigned

Dec 12, 2017

Last updated

Jul 11, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1801301858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23840 PURITAN RD",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441232246",
            "telephone_number": "216-224-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23215 COMMERCE PARK",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "216-224-7331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADLEY",
        "first_name": "MIRANDA",
        "middle_name": "KIMBERLY",
        "name_prefix": "Ms.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.1801112",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.0031105",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah L Wade, PA
• Tyler Markum Wade, LPC
• Willie Wade, CDCA
• Breanna Wadel
• Kelly L Wadeson, PHD
• Susan Gries Wager, MD
• Ann-Marie Waggoner, CNP
• Steven Waggoner, MD
• Nisheet Waghray, MD
• Pratik Wagle, DO

• Professional Counselor in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; 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.