Provider Demographics
NPI:1952626897
Name:CHENIK, LIZBETH ANN (LMFT)
Entity Type:Individual
Prefix:
First Name:LIZBETH
Middle Name:ANN
Last Name:CHENIK
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 1:44100 MONTEREY AVE STE 216M
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-2718
Mailing Address - Country:US
Mailing Address - Phone:760-834-8956
Mailing Address - Fax:760-340-3846
Practice Address - Street 1:44100 MONTEREY AVE STE 216M
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-2718
Practice Address - Country:US
Practice Address - Phone:760-834-8956
Practice Address - Fax:760-340-2846
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-04
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT51305106H00000X
CA51305106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty