Provider Demographics
NPI:1407642119
Name:FAIRFIELD, MIRANDA (LMSW)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:
Last Name:FAIRFIELD
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:MIRANDA
Other - Middle Name:
Other - Last Name:KINSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:850 MILL ST STE 100
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1463
Mailing Address - Country:US
Mailing Address - Phone:775-538-6700
Mailing Address - Fax:
Practice Address - Street 1:850 MILL ST STE 100
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1463
Practice Address - Country:US
Practice Address - Phone:775-538-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12183-M104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker