Miranda Green, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2020011992 Issued in MO

Practice address

851 E 5TH St Ste 154
Washington, MO 63090-3136

Phone

(314) 251-6663

NPI assigned

May 16, 2022

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

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 and National Provider Directory roles.

• Mercy Clinic Adult Hospitalists - Washington, LLC

  • Hospitalist Physician
  • Washington, MO
  • NPI 1891943429
  NPD

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1942947478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 GREEN LN",
            "city": "SAINT CLAIR",
            "state": "MO",
            "postal_code": "630773443",
            "telephone_number": "636-584-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 E 5TH ST STE 154",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903136",
            "telephone_number": "314-251-6663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1351 Jefferson St Ste 111",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "MO",
            "postal_code": "630906449",
            "country_code": "US",
            "telephone_number": "636-584-1205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MIRANDA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-16",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2020011992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• D. Bruce Glover Jr., D.O.
• Emily Jane Glover, MD
• Sudhanshu Gogia, MD
• Marilou Grainger, CRNA
• Ashley M Gratza, FNP
• Jill Grgurich
• Melissa Danielle Grim, LICENSED TATTOO ARTI
• Tammy Grim, HAIR LOSS PRACTIONER
• Sharon A. R. Grimes, RN, MSN, CPNP
• Alexandria Colleen Grodie, PMHNP

• Professional Counselor in Washington, MO
• Providers in Washington, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.