Leora Mirkin Therapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

LEORA MIRKIN THERAPY LLC

Doing business as

Pride Counseling Services of Wisconsin

Practice address

2614 Ravenswood Rd
Madison, WI 53711-4053

Phone

(608) 406-3860

Fax

(608) 403-4257

NPI assigned

Aug 9, 2021

Last updated

Aug 9, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Leora Mirkin, LCSWNPI 1942653340

Title

Owner/Operator and Therapist

Phone

(608) 406-3860

Specialties & licenses 1

Addresses

Other names 1

• Pride Counseling Services of Wisconsin Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leora Mirkin

  • Clinical Social Worker
  • Madison, WI
  • NPI 1942653340
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628467200000",
    "number": "1588339949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2614 RAVENSWOOD RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537114053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 RAVENSWOOD RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537114053",
            "telephone_number": "608-406-3860",
            "fax_number": "608-403-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEORA MIRKIN THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A",
        "authorized_official_last_name": "MIRKIN",
        "authorized_official_first_name": "LEORA",
        "authorized_official_title_or_position": "OWNER/OPERATOR AND THERAPIST",
        "authorized_official_telephone_number": "608-406-3860",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pride Counseling Services of Wisconsin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shawn Leonard, MD
• Vada Leong, MS
• Lucas Gregory Leonhard, M.D.
• Peter Leonhard, DC
• Peter F Leonovicz Jr., MD
• Nicholas Lepa, M.D.
• Alexander J. Lepak, M.D.
• Lisa M. Lepeak, M.D.
• Molly Kathleen Lepic, D.O.
• Susan M Lepinski, MD

• Clinical Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.