Provider Demographics
NPI:1083388599
Name:GIVENS, MARIYAH (AMFT)
Entity Type:Individual
Prefix:
First Name:MARIYAH
Middle Name:
Last Name:GIVENS
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12750 CENTRALIA ST UNIT 211
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90715-2429
Mailing Address - Country:US
Mailing Address - Phone:562-881-4100
Mailing Address - Fax:
Practice Address - Street 1:12750 CENTRALIA ST UNIT 211
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90715-2429
Practice Address - Country:US
Practice Address - Phone:562-881-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-07
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist