Healthcare Provider Details

I. General information

NPI: 1225656135
Provider Name (Legal Business Name): MIRNOSA LLC, COUNSELING & COACHING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 BETHESDA METRO CENTER SUITE 700
BETHESDA MD
20814
US

IV. Provider business mailing address

PO BOX 5473
WASHINGTON DC
20016-1073
US

V. Phone/Fax

Practice location:
  • Phone: 301-641-0136
  • Fax:
Mailing address:
  • Phone: 301-641-0136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. MIRIAN NOEMA SANCHEZ
Title or Position: CEO/OWNER
Credential: LCPC
Phone: 301-641-0136