Provider Demographics
NPI:1306218862
Name:MAHAKIAN, LAUREN KRISTINA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:KRISTINA
Last Name:MAHAKIAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 MANZANITA AVENUE
Mailing Address - Street 2:SUITE 6, #434
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-1770
Mailing Address - Country:US
Mailing Address - Phone:916-877-6894
Mailing Address - Fax:
Practice Address - Street 1:4125 TEMESCAL STREET
Practice Address - Street 2:SUITE A
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-9562
Practice Address - Country:US
Practice Address - Phone:916-877-6894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW821461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical