Provider Demographics
NPI:1669070561
Name:IRVING, YAZMEEN NILAJA (LCMHC)
Entity type:Individual
Prefix:MRS
First Name:YAZMEEN
Middle Name:NILAJA
Last Name:IRVING
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 PAVERSTONE DR
Mailing Address - Street 2:BOX 12
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4708
Mailing Address - Country:US
Mailing Address - Phone:919-995-8995
Mailing Address - Fax:984-202-2089
Practice Address - Street 1:901 PAVERSTONE DR STE 12
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4708
Practice Address - Country:US
Practice Address - Phone:919-995-8995
Practice Address - Fax:984-202-2089
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15997101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health