Tammy Miranda, LCPC-C, CBIS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

XL4898 Issued in ME

Practice address

1486B Broadway
South Portland, ME 04106-2602

Phone

(207) 602-8660

NPI assigned

Feb 20, 2018

Last updated

Apr 25, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

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

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health Affiliates Maine, LLCGroup PAC ID 1951594076, 169 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Health Affiliates Maine, LLC

  • Community/Behavioral Health Agency
  • Auburn, ME
  • NPI 1932413556
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1841790458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 SCHOOL ST",
            "city": "OLD ORCHARD BEACH",
            "state": "ME",
            "postal_code": "040642234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1486B BROADWAY",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062602",
            "telephone_number": "207-602-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "TAMMY",
        "credential": "LCPC-C, CBIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "XL4898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Janet Milovanovic
• Mind Your Mouth, PA, LLC
• Mindful Wellness LLC
• Minuteclinic Diagnostic of Maine, LLC
• Minuteclinic Diagnostic of Maine, LLC
• Mishla Dean, LCSW, LLC
• Lyndsay Mitsopoulos, IBCLC
• John Mladucky, PA-C
• Moby RX
• Judith Moll, LCSW

• Mental Health Counselor in South Portland, ME
• Providers in South Portland, ME by specialty
• Mental Health Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.