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General NPI Number Information
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NPI Number | 1881051621
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Entity Type | Individual
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Provider Name | MIRANDA KAY PAULSON MPS, LADC, LPCC
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Gender | Female
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Dates
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Enumeration Date | 01/25/2016
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 20 3RD ST NE
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City | AITKIN
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State | MN
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Zip | 56431-1422
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Country | US
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Telephone | 218-326-1274
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Fax |
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Provider Business Mailing Address
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Address Line | 43747 250TH STREET
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City | AITKIN
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State | MN
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Zip | 56431
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Country | US
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Telephone | 218-251-3719
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1816
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 304409
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License Number State | MN
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