Provider Demographics
NPI:1821155292
Name:NIRMUL, NIRMALA D (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NIRMALA
Middle Name:D
Last Name:NIRMUL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 DEER RUN DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN TOP
Mailing Address - State:PA
Mailing Address - Zip Code:18707-1965
Mailing Address - Country:US
Mailing Address - Phone:570-474-0192
Mailing Address - Fax:
Practice Address - Street 1:359 S MOUNTAIN BLVD
Practice Address - Street 2:SUITE C2
Practice Address - City:MOUNTAIN TOP
Practice Address - State:PA
Practice Address - Zip Code:18707-1984
Practice Address - Country:US
Practice Address - Phone:570-403-5080
Practice Address - Fax:570-403-5079
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACWO147761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01875940Medicaid
PA01875940Medicaid