Provider Demographics
NPI:1457749764
Name:MAHAJAN, GEETI SHIRAZI (LCSW, MPH, PYT)
Entity Type:Individual
Prefix:
First Name:GEETI
Middle Name:SHIRAZI
Last Name:MAHAJAN
Suffix:
Gender:F
Credentials:LCSW, MPH, PYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 GREEN CLIFFS RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-1274
Mailing Address - Country:US
Mailing Address - Phone:512-632-9700
Mailing Address - Fax:
Practice Address - Street 1:1706 NUECES ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1108
Practice Address - Country:US
Practice Address - Phone:512-632-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX563621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical