Provider Demographics
NPI:1194886184
Name:MIKHAIL, IRINI H (MSED, NCC, LPC)
Entity type:Individual
Prefix:
First Name:IRINI
Middle Name:H
Last Name:MIKHAIL
Suffix:
Gender:F
Credentials:MSED, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 VIP DR STE 310
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-6936
Mailing Address - Country:US
Mailing Address - Phone:724-934-3905
Mailing Address - Fax:
Practice Address - Street 1:117 VIP DR STE 310
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-6936
Practice Address - Country:US
Practice Address - Phone:412-495-8847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2020-09-23
Deactivation Date:2018-11-28
Deactivation Code:
Reactivation Date:2020-02-13
Provider Licenses
StateLicense IDTaxonomies
PAPC002718101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC002718OtherPA LICENSURE