Provider Demographics
NPI:1861536179
Name:SCHOOLEY, MIRANDA HEATH (LPC, LCAS)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:HEATH
Last Name:SCHOOLEY
Suffix:
Gender:F
Credentials:LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3084
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-3084
Mailing Address - Country:US
Mailing Address - Phone:828-265-1455
Mailing Address - Fax:828-265-1535
Practice Address - Street 1:368 CLINT NORRIS RD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-8843
Practice Address - Country:US
Practice Address - Phone:828-265-1455
Practice Address - Fax:828-265-1535
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3030101Y00000X
NC59101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102352Medicaid