Healthcare Provider Details

I. General information

NPI: 1780209163
Provider Name (Legal Business Name): NADIYA MIRAKI MS, LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2020
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

976 MARTIN LUTHER KING JR BLVD STE 200
CHAPEL HILL NC
27514-2654
US

IV. Provider business mailing address

976 MARTIN LUTHER KING JR BLVD STE 200
CHAPEL HILL NC
27514-2654
US

V. Phone/Fax

Practice location:
  • Phone: 919-442-8274
  • Fax: 984-309-2513
Mailing address:
  • Phone: 919-442-8274
  • Fax: 984-309-2513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14884
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: