MIRANDA GREENWOOD (LPC) – Professional Counselor, NPI 1053011874

MIRANDA GREENWOOD (LPC) is a healthcare provider. based in Greenfield, Wisconsin. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. 10291-125 (WI). The NPI Number for MIRANDA GREENWOOD (LPC) is 1053011874

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
MIRANDA GREENWOOD (LPC)
NPI
1053011874
Phone
(262) 442-2782
Address
4811 S 76TH ST STE 208
Enumeration Date
9 March 2023
Last Update Date
19 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2627891191
Graduation Year
2021 (5 years ago)
PAC ID
9133572506
Group Practice PAC ID
1456256023
Professional Enrollment ID
I20240201001957
Address ID
WI531328885FR9809XDRXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Digital endpointsOther names

1,748 MENTAL HEALTH COUNSELOR in WI

Provider Addresses for MIRANDA GREENWOOD (LPC)

  • 4811 S 76TH ST STE 208

    GREENFIELD, WI 532204352

    Phone: (262) 442-2782

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240201001957IMental Health CounselorWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 53220)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1456256023View full group profile
NameSpecialtyState
Mental Health CounselorWI
Marriage And Family TherapistWI
-WI
Nurse PractitionerIL
Mental Health CounselorWI
Mental Health CounselorWI
Mental Health CounselorAZ
Mental Health CounselorWI
Mental Health CounselorWI
Mental Health CounselorWI

Reviews

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Frequently asked questions

What is the 10-digit NPI for MIRANDA GREENWOOD (LPC)?
MIRANDA GREENWOOD (LPC) — NPI 1053011874 — is the standard way to identify this listing.
Does the file indicate MIRANDA GREENWOOD (LPC) is practicing under active NPI?
Directory data currently reports MIRANDA GREENWOOD (LPC) as active.
What is MIRANDA GREENWOOD (LPC)'s specialty?
The listing groups MIRANDA GREENWOOD (LPC) with Professional Counselor. Clinical services aligned with this taxonomy classification.
What address line appears for MIRANDA GREENWOOD (LPC)?
MIRANDA GREENWOOD (LPC)'s geographic hint is Greenfield, Wisconsin in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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