Provider Demographics
NPI:1063204840
Name:MIRZAKHANI, YASAMAN (LMHC)
Entity type:Individual
Prefix:MS
First Name:YASAMAN
Middle Name:
Last Name:MIRZAKHANI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 HOLBROOK ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:NORFOLK
Mailing Address - State:MA
Mailing Address - Zip Code:02056
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:65 HOLBROOK ST
Practice Address - Street 2:SUITE 220
Practice Address - City:NORFOLK
Practice Address - State:MA
Practice Address - Zip Code:02056
Practice Address - Country:US
Practice Address - Phone:781-742-4515
Practice Address - Fax:508-377-3752
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health