Provider Demographics
NPI:1598782021
Name:MIKLAVIC, LAURIE H (MED LPC)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:H
Last Name:MIKLAVIC
Suffix:
Gender:F
Credentials:MED LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 REEDSDALE STREET
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15233
Mailing Address - Country:US
Mailing Address - Phone:412-323-8026
Mailing Address - Fax:412-323-4507
Practice Address - Street 1:330 SOUTH 9TH STREET
Practice Address - Street 2:SOUTH 9TH STREET CENTER
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203
Practice Address - Country:US
Practice Address - Phone:412-488-4040
Practice Address - Fax:412-488-4932
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004144101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional