MEDICARE: JOANNA MIKHAIL PLPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	2018035213	MO

General Provider Information

NPI Number	:	1487298022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNA MIKHAIL PLPC

Provider Business Mailing Address
First Line	:	3002 INDIANA AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63118-1626
Country	:	US
Telephone Number	:	614-530-2432
Fax Number	:

Provider Business Practice Location Address
First Line	:	2838 S GRAND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63118-1033
Country	:	US
Telephone Number	:	614-530-2432
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2019
Last Update Date	:	10/19/2023

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