Provider Demographics
NPI:1093404774
Name:BOGASKI, MIKAYLA (MS)
Entity Type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:
Last Name:BOGASKI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 PROGRESS ST APT 408
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-5990
Mailing Address - Country:US
Mailing Address - Phone:412-266-1975
Mailing Address - Fax:
Practice Address - Street 1:1010 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-2322
Practice Address - Country:US
Practice Address - Phone:412-228-0173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health