Organization
LEORA MIRKIN THERAPY LLC
Active
Other names
Pride Counseling Services of Wisconsin
Organization subpart
No
Provider details
NPI number
Authorized official
LEORA MIRKIN LCSW (OWNER/OPERATOR AND THERAPIST)
(608) 406-3860
Entity
Organization
Contact information
Practice address
2614 RAVENSWOOD RD, MADISON, WI 53711-4053
(608) 406-3860
(608) 403-4257
Mailing address
2614 RAVENSWOOD RD, MADISON, WI 53711-4053
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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