Provider Demographics
NPI:1679610828
Name:AMAYA, MIRNA (LPC)
Entity Type:Individual
Prefix:MS
First Name:MIRNA
Middle Name:
Last Name:AMAYA
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 1:1725 LANIER PL NW
Mailing Address - Street 2:#26D
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-2182
Mailing Address - Country:US
Mailing Address - Phone:202-669-4668
Mailing Address - Fax:
Practice Address - Street 1:7412 GEORGIA AVE NW
Practice Address - Street 2:#4
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1754
Practice Address - Country:US
Practice Address - Phone:202-413-7837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X
DCPRC13809101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant