Kimberly S. Miron, LMSW
Individual provider Active NPI Clinical Social Worker · Skanee, MI
NPI 1992056824 · NPPES record last updated Sep 4, 2026
Key facts
- NPI
- 1992056824
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6801073221 (MI)
- Practice address
- 13080 Borealis Rd
Skanee, MI 49962-9004 - Phone
- (906) 201-0248
- NPI assigned
- Oct 2, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801073221 | MI | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6801073221 | MI | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 6801073221 | MI | |
| Clinical Social Worker | 1041C0700X | 6801073221 | MI | Yes |
Addresses
Primary practice location
13080 Borealis Rd
Skanee, MI 49962-9004
Mailing address
13080 Borealis Rd
Skanee, MI 49962-9004
Phone (906) 201-0248
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0960978 | Other | MI | BCBS |
| 1841555430 | Other | MI | RHC MEDICAID NPI NUMBER |
| 23-8646 | Other | MI | RHC MEDICARE |
| 1992056824 | Medicaid | MI | |
| 6801073221 | Other | MI | CLINICAL SOCIAL WORKER LICENSE NUMBER |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.