Provider Demographics
NPI:1164857983
Name:BIAVA, PETER AUGUSTUS IV (MC LPC)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:AUGUSTUS
Last Name:BIAVA
Suffix:IV
Gender:M
Credentials:MC LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4270 N RILLITO CREEK PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-1162
Mailing Address - Country:US
Mailing Address - Phone:520-320-1984
Mailing Address - Fax:
Practice Address - Street 1:4270 N RILLITO CREEK PL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-1162
Practice Address - Country:US
Practice Address - Phone:520-320-1984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-2201101YM0800X, 101YA0400X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional