Provider Demographics
NPI:1154823730
Name:DIALLO, MICHAELA J (LPC, NCC, MED)
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:J
Last Name:DIALLO
Suffix:
Gender:F
Credentials:LPC, NCC, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 HILL AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-1914
Mailing Address - Country:US
Mailing Address - Phone:412-491-6334
Mailing Address - Fax:
Practice Address - Street 1:285 JOHNSON BLVD
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-1729
Practice Address - Country:US
Practice Address - Phone:724-335-2015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA81148118101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional