Provider Demographics
NPI:1902393838
Name:BUKIET, CHAYA M (LMFT)
Entity Type:Individual
Prefix:
First Name:CHAYA
Middle Name:M
Last Name:BUKIET
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 GLENRIDGE DR APT 313
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4920
Mailing Address - Country:US
Mailing Address - Phone:347-378-4123
Mailing Address - Fax:
Practice Address - Street 1:5450 GLENRIDGE DR APT 313
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4920
Practice Address - Country:US
Practice Address - Phone:347-378-4123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-17
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist