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General NPI Number Information
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NPI Number | 1669070561
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Entity Type | Individual
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Provider Name | YAZMEEN NILAJA IRVING LCMHC
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Gender | Female
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Dates
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Enumeration Date | 10/13/2020
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Last Update Date | 09/21/2024
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Provider Practice Location Address
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Address Line | 901 PAVERSTONE DR STE 12
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City | RALEIGH
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State | NC
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Zip | 27615-4708
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Country | US
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Telephone | 919-995-8995
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Fax | 984-202-2089
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Provider Business Mailing Address
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Address Line | 901 PAVERSTONE DR BOX 12
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City | RALEIGH
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State | NC
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Zip | 27615-4708
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Country | US
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Telephone | 919-995-8995
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Fax | 984-202-2089
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 15997
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License Number State | NC
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