Provider Demographics
NPI:1639342165
Name:CHEUNG, MAKAYLAH (LCSW)
Entity Type:Individual
Prefix:
First Name:MAKAYLAH
Middle Name:
Last Name:CHEUNG
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 1:4444 W RIVERSIDE DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4073
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4444 W RIVERSIDE DR
Practice Address - Street 2:SUITE 205
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4073
Practice Address - Country:US
Practice Address - Phone:323-317-7437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS278541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical