Miranda K Botts, MA, LPC, LAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4787 Issued in CO

Practice address

515 28 3/4 Rd
Grand Junction, CO 81501-5016

Phone

(970) 241-6023

Fax

(970) 242-8330

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Miranda K Moyer Former name

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Grand Junction Creative Therapies

  • Professional Counselor
  • Grand Junction, CO
  • NPI 1265904494
  NPD (past) Authorized official

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1871687491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 KEYSTONE CT",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815066011",
            "telephone_number": "970-201-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 28 3/4 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815015016",
            "telephone_number": "970-241-6023",
            "fax_number": "970-242-8330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2820 Keystone Ct",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815066011",
            "country_code": "US",
            "telephone_number": "970-201-8911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTTS",
        "first_name": "MIRANDA",
        "middle_name": "K",
        "credential": "MA, LPC, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "180",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "4787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "MOYER",
            "middle_name": "K",
            "credential": "MA, LPC, LAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Scott R Bordon, RPH
• Alison Lea Bormann, RN
• Molli Boruff
• Shannon Bostrom, M.S., CCC-SLP
• Jessica S. Botkin, B.A.
• Teresa T. Bou-Matar, LPC
• James Marcus Bougie, PHARMD
• Bounce Back Counseling Services, LLC
• Bounce Back Counseling Services, LLC
• Paulette Yvonne Bourget, LMT

• Professional Counselor in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.