Provider Demographics
NPI:1528519436
Name:MIRAVALLE, JOSEPH (LPC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:MIRAVALLE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 PENN CENTER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-5928
Mailing Address - Country:US
Mailing Address - Phone:412-731-9707
Mailing Address - Fax:
Practice Address - Street 1:777 PENN CENTER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-5928
Practice Address - Country:US
Practice Address - Phone:412-731-9707
Practice Address - Fax:412-829-8121
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
PAPC017305101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor