MIRANDA L BACKES (NPI# 1902459910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902459910 |
| Entity Type | Individual |
| Full Name | MIRANDA L BACKES |
| Credential | PLPC |
| Practice Address |
1432 Southwest Blvd Jefferson City MO 65109-2444 |
| Practice Telephone | 5736325560 |
| Mailing Telephone | 5736325560 |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
1432 SOUTHWEST BLVD |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65109-2444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639166481 | Shelby D Rifkin | Internal Medicine | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2005-10-05 |
| 1942816897 | Ashley Nicole Bramer | Speech-Language Pathologist | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2020-09-16 |
| 1891319877 | Derek Scott Parker | Physical Therapist | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2020-06-04 |
| 1205489630 | Jamie Lynn Wilson | Social Worker | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2019-07-24 |
| 1356809297 | Stacy Lynn Stegeman | Counselor | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2019-03-11 |
| 1295207371 | Mary Blochberger | Specialist/Technologist | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2018-12-29 |
| 1053714154 | Wesley Clifford Thompson | Psychologist | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2014-10-02 |
| 1235473380 | Nicole Danielle Borrenpohl | Nurse Practitioner | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2012-11-15 |
| 1679825244 | Capital Region Medical Center | Radiology | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2012-10-08 |
| 1982953196 | Lynn Margaret Grant | Dietitian, Registered | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2012-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518449321 | Kara D Roderick | Physical Therapist | 1115 Fairgrounds Road, Jefferson City, MO 65109 | 2018-08-29 |
| 1851871214 | Integrative Medicine, LLC | Internal Medicine | 999 Diamond Rdg Ste 201, Jefferson City, MO 65109 | 2018-08-15 |
| 1972020394 | Rehab Care Group East, LLC | Clinic/Center | Primrose Retirement Community Jefferson City, 1214 Freedom Boulevard, Jefferson City, MO 65109 | 2017-08-25 |
| 1124558986 | Nicholas Rehagen | Specialist/Technologist | 304 Timber Creek Rd, Jefferson City, MO 65109 | 2017-06-14 |
| 1982004214 | Kara Elizabeth Wilbers | Occupational Therapist | 1105 Fairgrounds Rd, Jefferson City, MO 65109 | 2014-08-22 |
| 1942510334 | Loftin Eyecare, LLC | Optometrist | 724 West Stadium Boulevard, # 029 Walmart Vision Center, Jefferson City, MO 65109 | 2010-10-19 |
| 1306077250 | Paula Hancock Johnson | Social Worker | 1303 Edgewood Dr Ste 5, Jefferson City, MO 65109 | 2009-07-27 |
| 1679701296 | Capital Region Medical Center | Family Medicine | 3308 W Edgewood, Suite B, Jefferson City, MO 65109 | 2009-06-23 |
| 1972730141 | Nancy S Stork | Counselor | 204 Metro, Suite B, Jefferson City, MO 65109 | 2009-06-16 |
| 1356522916 | Walk Easy LLC | Durable Medical Equipment & Medical Supplies | 4810 Rainbow Dr., Jefferson City, MO 65109 | 2007-11-23 |
| Find all providers in zip 65109 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700433364 | Sarah Emily Williamson | Counselor | 321 W Broadway Blvd, Jefferson City, TN 37760-3103 | 2019-08-19 |
| 1992179899 | Tricia Orscheln | Counselor | 2418 Hyde Park Rd, Jefferson City, MO 65109-4731 | 2015-11-16 |
| 1366682692 | Professional Associates | Counselor | 1115 Hermits Ln, Jefferson City, MO 65109-3239 | 2009-02-26 |
| 1659534386 | Cynthia L Hackathorn | Counselor | 1706 E Elm St, Jefferson City, MO 65102 | 2008-07-02 |
| 1699974063 | F.d. Professional Counseling Service, Inc | Counselor | 129 E High St, Suite A, Jefferson City, MO 65101-5401 | 2007-07-16 |
| 1972634038 | Scott O'kelley | Counselor | 211 Oscar Dr Ste A, Jefferson City, MO 65101-5197 | 2007-03-08 |
| 1528105905 | Alisha L Cobb | Counselor | 1806 Marble Ave, Jefferson City, TN 37760-2010 | 2007-02-01 |
| 1316579659 | Robert William Smith | Counselor | 227 Metro Dr, Jefferson City, MO 65109-1134 | 2020-02-05 |
| 1073156998 | Michele Ernst Christman | Counselor | 1905 Stadium Blvd, Jefferson City, MO 65109-1961 | 2019-10-23 |
| 1033752209 | Chloe Payton Rimer | Counselor | 1905 Stadium Blvd, Jefferson City, MO 65109-1961 | 2019-10-21 |
| Find all providers in JEFFERSON CITY | ||||
| City | JEFFERSON CITY |
| Zip Code | 65109 |
Please comment or provide details below to improve the information on MIRANDA L BACKES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.