Provider Demographics
NPI:1336795608
Name:LYUBOV BURGINA INC.
Entity Type:Organization
Organization Name:LYUBOV BURGINA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:MS
Authorized Official - First Name:LYUBOV
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-606-3200
Mailing Address - Street 1:14903 S NORMANDIE AVE APT 214
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-2968
Mailing Address - Country:US
Mailing Address - Phone:323-606-3200
Mailing Address - Fax:323-849-3396
Practice Address - Street 1:14903 S NORMANDIE AVE APT 214
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-2968
Practice Address - Country:US
Practice Address - Phone:323-606-3200
Practice Address - Fax:323-849-3396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-13
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty