Provider Demographics
NPI:1659662476
Name:VIRAGO, JESSE A (LPC)
Entity Type:Individual
Prefix:MS
First Name:JESSE
Middle Name:A
Last Name:VIRAGO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6928 MEADE STREET
Mailing Address - Street 2:NO. 3
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208
Mailing Address - Country:US
Mailing Address - Phone:412-362-6002
Mailing Address - Fax:
Practice Address - Street 1:6928 MEADE STREET
Practice Address - Street 2:NO. 3
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15208
Practice Address - Country:US
Practice Address - Phone:412-362-6002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005829101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional