Provider Demographics
NPI:1376325035
Name:MIRIAN, BAHAREH (LPC-S, ATR)
Entity Type:Individual
Prefix:
First Name:BAHAREH
Middle Name:
Last Name:MIRIAN
Suffix:
Gender:F
Credentials:LPC-S, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 PRESS DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126
Mailing Address - Country:US
Mailing Address - Phone:504-603-7136
Mailing Address - Fax:
Practice Address - Street 1:1122 DESIRE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70117-6110
Practice Address - Country:US
Practice Address - Phone:504-603-7136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional