Provider Demographics
NPI:1144315516
Name:SKLAROFF, MIKAL ERIC (LPC)
Entity type:Individual
Prefix:MR
First Name:MIKAL
Middle Name:ERIC
Last Name:SKLAROFF
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1931 J N PEASE PL
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-4544
Mailing Address - Country:US
Mailing Address - Phone:704-402-8886
Mailing Address - Fax:877-735-1698
Practice Address - Street 1:1931 J N PEASE PL
Practice Address - Street 2:SUITE 201
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4543
Practice Address - Country:US
Practice Address - Phone:704-402-8886
Practice Address - Fax:877-735-1698
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5143101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6008471Medicaid
NC6103187Medicaid