Provider Demographics
NPI:1780865733
Name:BAUER, MARIYA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIYA
Middle Name:
Last Name:BAUER
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 1:429 SANTA MONICA BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-3401
Mailing Address - Country:US
Mailing Address - Phone:310-924-2917
Mailing Address - Fax:
Practice Address - Street 1:429 SANTA MONICA BLVD
Practice Address - Street 2:STE 200
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-3401
Practice Address - Country:US
Practice Address - Phone:310-924-2917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health