Provider Demographics
NPI:1164839197
Name:AMIRIAN, GAREN (LMHC)
Entity Type:Individual
Prefix:
First Name:GAREN
Middle Name:
Last Name:AMIRIAN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HAYWARD AVE
Mailing Address - Street 2:APT 2F
Mailing Address - City:FLEETWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:10552-1718
Mailing Address - Country:US
Mailing Address - Phone:914-297-7983
Mailing Address - Fax:
Practice Address - Street 1:156 W 86TH ST
Practice Address - Street 2:STE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4002
Practice Address - Country:US
Practice Address - Phone:914-297-7983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006192101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health