Provider Demographics
NPI:1548973787
Name:NIRELLA, LAURA (NCC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:NIRELLA
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3427 THORNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1462
Mailing Address - Country:US
Mailing Address - Phone:412-706-2641
Mailing Address - Fax:
Practice Address - Street 1:243 JOHNSTON RD
Practice Address - Street 2:
Practice Address - City:UPPER SAINT CLAIR
Practice Address - State:PA
Practice Address - Zip Code:15241-2534
Practice Address - Country:US
Practice Address - Phone:412-833-6444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC01508101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional