Provider Demographics
NPI:1164914644
Name:ELIZABETH MIRANDA COUNSELING LLC
Entity Type:Organization
Organization Name:ELIZABETH MIRANDA COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RAEANN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MIRANDA
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT
Authorized Official - Phone:913-961-9655
Mailing Address - Street 1:11111 NALL AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1622
Mailing Address - Country:US
Mailing Address - Phone:913-961-9655
Mailing Address - Fax:
Practice Address - Street 1:11111 NALL AVE STE 102
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1622
Practice Address - Country:US
Practice Address - Phone:913-961-9655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty