Provider Demographics
NPI:1902026685
Name:MIRANDA, JOANITA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JOANITA
Middle Name:
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 GLENGARRY WAY
Mailing Address - Street 2:
Mailing Address - City:WEST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-3011
Mailing Address - Country:US
Mailing Address - Phone:609-716-7107
Mailing Address - Fax:
Practice Address - Street 1:8 GLENGARRY WAY
Practice Address - Street 2:
Practice Address - City:WEST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08550-3011
Practice Address - Country:US
Practice Address - Phone:609-716-7107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC005972001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical