Provider Demographics
NPI:1174096168
Name:TAKOOSH ABRAHAMIAN
Entity type:Organization
Organization Name:TAKOOSH ABRAHAMIAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TAKOOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:818-644-9920
Mailing Address - Street 1:17715 CHATSWORTH ST STE 208
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-5660
Mailing Address - Country:US
Mailing Address - Phone:818-644-9920
Mailing Address - Fax:818-337-0440
Practice Address - Street 1:17715 CHATSWORTH ST STE 208
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-5660
Practice Address - Country:US
Practice Address - Phone:818-644-9920
Practice Address - Fax:818-337-0440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-02
Last Update Date:2019-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty